Abdominal obesity (AO) in women exhibits clinical heterogeneity, yet its neural mechanisms remain unclear. Using diffusion tensor imaging (DTI), this study conducts the first systematic investigation of whole-brain white matter (WM) structural network topological properties and female-specific neural mechanisms in AO patients stratified by appetite subtypes (strong appetite, SA; moderate appetite, MA). This study enrolled 60 female AO patients (stratified into 30 SA and 30 MA) and 30 age-matched healthy controls (HCs). Whole-brain WM structural networks were constructed, with global and local topological properties analyzed through graph theoretical approaches. Statistical correlations between network metrics and clinical measures were assessed. Global network analysis demonstrated intact small-world properties (γ > 1, σ > 1) across all groups. At the nodal level, compared with HCs, SA patients showed reduced degree centrality (DC) in the right temporal pole: superior temporal gyrus (TPOsup. R) (p = 0.017) and lower nodal local efficiency (NLE) in the right amygdala (AMYG. R) (p = 0.007). Notably, TPOsup. R DC positively correlated with appetite scores (r = 0.408, p = 0.025). Additionally, the SA group exhibited reduced betweenness centrality (BC) in the right rectus gyrus (REC. R) compared to the MA group (p = 0.041), which negatively correlated with appetite scores (r = -0.439, p = 0.015). Conversely, MA patients showed increased NLE in the right medial orbital superior frontal gyrus (ORBsupmed. R) (p = 0.005). Whole-brain connectome analysis identified a hypo-connected subnetwork specific to MA involving 23 nodes and 24 edges, highlighting weakened right amygdala (AMYG. R)-right superior occipital gyrus (SOG. R) (r = 0.464, p = 0.01) and right lingual gyrus (LING. R)-right fusiform gyrus (FFG. R) (r = 0.365, p = 0.047) connections that showed positive correlation with waist circumference. In summary, this study provides the first evidence that female patients with abdominal obesity exhibiting different appetite phenotypes possess specific white matter structural network patterns. The SA subtype is characterized by aberrant nodal topological properties within prefrontal-limbic circuits, reflecting a localized disruption associated with heightened appetite. In contrast, the MA subtype is defined by widespread structural disconnectivity between occipital sensory areas and limbic regions, appearing as a neuroanatomical consequence linked to abdominal adiposity severity.

Response variability limits the clinical utility of transcutaneous auricular vagus nerve stimulation (taVNS) for negative symptoms in treatment-resistant schizophrenia (TRS). This study aimed to develop an electroencephalography (EEG)-based machine learning (ML) model to predict individual response and explore associated neurophysiological mechanisms. We used ML to develop and validate predictive models based on pre-treatment EEG data features (power, coherence, and dynamic functional connectivity) from 50 TRS patients enrolled in the taVNS trial, within a nested cross-validation framework. Participants received 20 sessions of active or sham taVNS (n = 25 each) over two weeks, followed by a two-week follow-up. The prediction target was the percentage change in the positive and negative syndrome scale-factor score for negative symptoms (PANSS-FSNS) from baseline to post-treatment, with further evaluation of model specificity and neurophysiological relevance.The optimal model accurately predicted taVNS response in the active group, with predicted PANSS-FSNS changes strongly correlated with observed changes (r = 0.87, p < .001); permutation testing confirmed performance above chance (p < .001). Nine consistently retained features were identified, predominantly fronto-parietal and fronto-temporal coherence features. Negligible predictive performance in the sham group and failure to predict positive symptom change support the predictive specificity of this oscillatory signature for taVNS-related negative symptom improvement. Two coherence features within fronto-parietal-temporal networks showed post-taVNS changes significantly associated with symptom improvement, suggesting dual roles as predictors and potential therapeutic targets. EEG oscillatory neuromarkers enable accurate prediction of individual taVNS response in TRS, supporting mechanism-informed precision neuromodulation strategies.

Negative symptoms of schizophrenia (NSS) represent a core feature of the disorder associated with substantial disease burden and poor functional prognosis, yet current therapeutic options remain limited. Given this unmet clinical need, we will explore the therapeutic potential of a combined non-pharmacological intervention using transcutaneous auricular vagus nerve stimulation (taVNS) and transcutaneous electrical acupoint stimulation (TEAS). In this single-blind, prospective, randomized controlled trial utilizing a 2 × 2 factorial design, 120 NSS participants will be randomly assigned in a 1:1:1:1 ratio to four groups: taVNS plus TEAS, taVNS plus sham TEAS, sham taVNS plus TEAS, and sham taVNS plus sham TEAS. Participants will receive 30-minute treatment sessions every other day for 4 weeks, with a subsequent 4-week follow-up period. The primary outcome is the reduction in the Positive and Negative Syndrome Scale-Factor Score for Negative Symptoms (PANSS-FSNS) at the end of the intervention at week 4 relative to baseline. This study aims to evaluate the individual and combined efficacy and safety of taVNS and TEAS in the treatment of NSS. Additionally, dual-modal synchronous electroencephalography (EEG) and electrocardiography (ECG) recordings will be used to investigate the neurophysiological mechanisms underlying the interventions and potential electrophysiological changes associated with the therapeutic effects. Trial registration: International Traditional Medicine Clinical Trial Registry (ITMCTR2025000634); registered on April 2, 2025.

BACKGROUND:Acute chemotherapy-related gastrointestinal symptoms can limit colorectal cancer treatment. We evaluated electroacupuncture as adjunctive care for acute gastrointestinal symptom burden during chemotherapy. METHODS:This multicenter, randomized, patient- and assessor-blinded, sham-controlled trial was conducted at 6 tertiary hospitals in China from July 2022 to August 2025. Adults with colorectal cancer and chemotherapy-related gastrointestinal symptoms were randomly assigned 1 1:1 to electroacupuncture, nonpenetrating sham acupuncture, or usual care. Treatments were given once daily for 3 days during chemotherapy. The primary outcome was change in Gastrointestinal Symptom Rating Scale (GSRS) total score from baseline to day 3. Secondary outcomes included rescue medication use and adverse events. RESULTS:Among 230 randomized patients (mean age, 60.1 years; 54.3% men), 211 (91.7%) completed the 3-day intervention. At day 3, electroacupuncture reduced GSRS total scores more than sham acupuncture (mean difference [MD], -1.54; 95% CI, -2.35 to -0.74; P < .001) and usual care (MD, -1.30; 95% CI, -2.09 to -0.50; P = .001). These differences did not exceed the prespecified minimal clinically important difference of 2.15 points. Electroacupuncture was associated with higher odds of remaining rescue-free than sham acupuncture (adjusted OR, 2.86; 95% CI, 1.23 to 6.63; P = .015) and usual care (adjusted OR, 2.64; 95% CI, 1.16 to 6.01; P = .021). No serious adverse events occurred. CONCLUSIONS:Electroacupuncture was associated with statistically significant but modest short-term reductions in acute gastrointestinal symptom burden. The between-group differences did not exceed the prespecified clinical-importance threshold and should be interpreted cautiously. TRIAL REGISTRATION:Chinese Clinical Trials Register identifier ChiCTR2200062317.

Background:Negative Symptoms of Schizophrenia (NSS) are the primary contributors to poor prognosis in schizophrenia (SCZ), and immune-inflammatory mechanisms play a pivotal role in their pathogenesis. As non-invasive neuromodulation techniques, transcutaneous auricular vagus nerve stimulation (taVNS), and transcutaneous electrical acupoint stimulation (TEAS) have been demonstrated to modulate peripheral inflammation levels in patients with SCZ. Purpose:This study aims to investigate the independent and synergistic effects of taVNS and TEAS on modulating peripheral inflammatory factors and ameliorating negative symptoms in patients with NSS. Patients and Methods:This study employs a single-blind, randomized, sham-controlled, 2×2 factorial design. A total of 108 participants will be randomly allocated in a 1:1:1:1 ratio to four groups: taVNS plus TEAS, active taVNS plus TEAS, sham taVNS plus TEAS, and sham taVNS plus sham TEAS. The interventions will be administered for 30 minutes per session on alternate days for 4 weeks, followed by a 4-week follow-up period. The primary outcome is the change from baseline in peripheral inflammatory cytokine levels at weeks 4 and 8. Results:Recruitment is ongoing. Conclusion:The study protocol aims to investigate the pre- and post-treatment changes in peripheral inflammatory cytokines among patients with NSS, with a specific focus on the correlation between symptom severity and alterations in inflammatory levels, thereby providing a biological rationale to guide clinical treatment.

Uterine contraction pain after spontaneous vaginal birth (SVB) hinders early maternal recovery. Transcutaneous auricular vagus nerve stimulation (taVNS), as a safe, and non-invasive alternative therapy, can alleviate pain and improve sleep and emotion. Although a recent trial has confirmed its benefits after cesarean delivery, direct evidence evaluating the clinical efficacy of taVNS among post-SVB populations remains absent. This is a single-center, prospective, sham-controlled, three-arm parallel-group randomized clinical trial. A total of 144 maternal participants after SVB will be enrolled and randomly assigned in a 1:1:1 ratio to the 1-Hz taVNS group, 20-Hz taVNS group, or the sham taVNS group. All participants will receive routine postpartum care and undergo a 30-minute daily intervention on the left ear for 3 consecutive days, beginning on the day of delivery. The primary outcome is the proportion of participants with a Visual Analog Scale (VAS) pain score ≥ 4 on postpartum day 3. Secondary outcomes include pain intensity and episode characteristics at other time points, rescue analgesia rate, lactation and breastfeeding status, vaginal bleeding, mood, sleep, and adverse events. Electrocardiogram (ECG) data will be monitored before and after each treatment session. This trial will evaluate the efficacy and safety of 1-Hz versus 20-Hz taVNS compared with sham stimulation for moderate-to-severe uterine contraction pain on postpartum day 3 among women after SVB, while assessing its effects on early recovery. Our findings may provide a rationale for scaling up this non-invasive technology in hospital settings, thereby contributing to improved postpartum care outcomes. International Traditional Medical Clinical Trial Registry (ITMCTR), ITMCTR2026001275. Prospectively registered on 7 June 2026.

Purpose:Vaginal delivery is the most common mode of childbirth, and women often experience severe uterine contraction pain (UCP) for several days postpartum, which can significantly impair postpartum recovery. Acupuncture has proven efficacy in the management of multiple pain conditions. This trial aimed to evaluate the analgesic efficacy and safety of acupuncture for managing postpartum UCP following vaginal delivery. Patients and Methods:This trial was designed as a prospective, randomized controlled trial with blinding of participants, outcome assessors, and data analysts. A total of 236 participants were planned for recruitment and were randomly assigned in a 1:1 ratio to either the Verum Acupuncture (VA) group or the Sham Acupuncture (SA) group. The VA group underwent verum acupuncture at four bilateral acupoints (ST36, LR3, SP8, and GB41), for a total of eight needling sites. The SA group received simulated needling with a non-penetrating blunt needle via the Park Sham Device (PSD). Acupuncture was administered twice daily for three consecutive days, starting on the day of vaginal delivery, with needles retained for 30 minutes per session. The primary outcome was defined as the UCP level assessed by the Visual Analog Scale (VAS) on postpartum day 3. Secondary outcomes included UCP levels at postpartum days 1, 2, 10, and 17, as well as the intensity, frequency, and duration of UCP, vaginal blood loss, lactation volume, and psychological scores measured by the Edinburgh Postnatal Depression Scale (EPDS), Self-Rating Anxiety Scale (SAS), and Short Form-36 Health Survey (SF-36). Conclusion:The research results are expected to provide credible evidence for the efficacy of acupuncture as a complementary treatment for UCP following vaginal delivery.

OBJECTIVE:This study aimed to evaluate the immediate analgesic efficacy of acupuncture in acute migraine without aura. BACKGROUND:Patients with acute migraine without aura require prompt relief from headache. Acupuncture has the potential to provide rapid pain relief; however, its analgesic efficacy warrants further validation. METHODS:We designed a single-blind, sham-controlled, randomized controlled trial and randomly allocated 80 patients with acute migraine without aura to the real acupuncture or the sham acupuncture group at a 1:1 ratio. Both groups received 10 min of real acupuncture or nonpenetrating blunt needling. The primary outcome was the analgesic response rate of patients at 10 min. RESULTS:This trial was conducted at the Second Affiliated Hospital, Yunnan University of Chinese Medicine from January 2023 to December 2024. All 80 patients provided complete data. At the primary end point of 10 min, the analgesic response rate was 92.5% (37 of 40) in the real acupuncture group compared to 12.5% (5 of 40) in the sham acupuncture group, with a between-group difference of 80.0% (95% confidence interval [CI], 64.4%-95.6%; p < 0.001). The real acupuncture group also demonstrated higher response rates from 2 to 8 min (differences ranging from 27.5% to 75.0%, all p < 0.05). At 1 min, the difference was 12.5% (95% CI, -0.2% to 25.2%; p = 0.995). Regarding pain intensity, the real acupuncture group exhibited a greater reduction in pain visual analog scale scores compared to the sham acupuncture group starting from 1 min (mean difference: -1.0; 95% CI, -1.3 to -0.6; p < 0.001) and peaking at 10 min (mean difference: -2.6; 95% CI, -3.0 to -2.2; p < 0.001). For accompanying symptoms, the real acupuncture group showed significantly lower scores for nausea/vomiting at 10 min (median [interquartile range (IQR)] 0.0 [0.0-1.0] vs. 1.0 [0.0-2.0]; p = 0.006), whereas no significant differences were observed for photophobia/phonophobia (median [IQR]: 0.0 [0.0-1.0] vs. 0.5 [0.0-2.0]; p = 0.098). No adverse events were observed during the trial. CONCLUSION:The results of this study demonstrate that acupuncture can rapidly alleviate headache and accompanying symptoms in patients with acute migraine without aura attacks within 10 min, with the analgesic effect of the real acupuncture group being significantly superior to that of the sham acupuncture group. Future trials are needed to verify the reliability and generalizability of our findings.

Background:Primary dysmenorrhea (PD) is a common gynecological disorder that significantly affects women's work and personal lives, especially in acute episodes when immediate pain relief is often needed. The objective of this study is to evaluate the immediate analgesic effect of acupuncture for acute PD within 10 min. Methods:This is a randomized sham-controlled clinical trial involving 80 participants with acute PD who will be randomized in a 1:1 ratio into the Acupuncture group and the Sham acupuncture group. Each participant will receive 10 min acupuncture session. For participants in the Sham acupuncture (SA) group, the Park Sham Acupuncture Device (PSD) and blunt needles will be used to simulate treatment without skin penetration. The visual analog scale (VAS) will be evaluated before treatment and at 0-1, 2, 4, 6, 8, and 10 min after treatment. The primary outcome is the effective analgesia rate after 10 min of acupuncture. Secondary outcomes include effective analgesia rate at other time points (0-1, 2, 4, 6, and 8 min), VAS, blinding assessment, and the treatment effectiveness expectations scale. Adverse events during each treatment period will be collected and recorded. All outcomes will be analyzed on an intention-to-treat. The recruitment for this study is expected to be completed between May 1, 2024, and September 1, 2025. Discussion:The primary need of patients with PD is the immediate relief of pain. This study aims to investigate the immediate analgesic effect of acupuncture on acute PD. The results of this study will provide a rapid and reliable clinical basis for the use of acupuncture in the treatment of PD, potentially offering a non-pharmacological alternative for pain management that could reduce reliance on medications and their associated side effects. Clinical trial registration:Identifier ChiCTR2300070826. This study has been registered at the Chinese Clinical Trial Registry (https://www.chictr.org.cn).

Purpose:Uterine contraction pain post-cesarean section (UCPCS) is one of the main complaints for mothers in the early stages of the puerperium. Acupuncture, a non-pharmacological therapy, has shown sound analgesic effects with almost no toxic side effects. This study uses acupuncture as an intervention and aimed to provide strong evidence for the clinical efficacy of acupuncture in treating UCPCS. Patients and Methods:This single-blind, randomized controlled trial (RCT) was conducted at the Ludian County Hospital of Traditional Chinese Medicine, China. Participants (138) are randomly assigned in a 1:1 ratio to either an observation or control group following cesarean section. Both groups receive routine postpartum care, the control group with sham acupuncture and the observation group with conventional acupuncture for 3 days. The primary outcome is the mean Visual Analogue Scale (VAS) score of the UCPCS. Secondary outcomes include the mean of UCPCS intensity, frequency, total duration, number of days to disappear, amount of vaginal bleeding and lactation, time to first lactation, and the Edinburgh Postnatal Depression Scale (EPDS) score. The final results will be analyzed in accordance with the intention-to-treat (ITT) principle using SPSS V.28.0. Discussion:This is the first RCT using non-penetrating sham acupuncture as a control to validate the clinical efficacy of acupuncture for UCPCS. The results of this study are expected to provide an effective therapeutic option for UCPCS, as well as offer clinicians and researchers strong evidence regarding non-pharmacological interventions.

INTRODUCTION:Primary hypertension (PH) affects over one billion individuals globally, yet less than 30% achieve controlled blood pressure (BP) with medication. Many patients require a combination of multiple medications to reach targets, but adverse effects and financial burdens undermine adherence. Additionally, prehypertension affects 25%-50% of adults, increasing the risk of cardiovascular complications. Early detection and management of prehypertension are crucial for delaying the need for pharmacological interventions. In recent years, clinical guidelines have increasingly emphasised non-pharmacological interventions for PH management. However, the diversity of non-pharmacological therapies and the inconsistencies in efficacy challenge clinical decision-making. This study aims to use network meta-analysis (NMA) to synthesise existing evidence on non-pharmacological interventions for PH, offering updated clinical insights and evidence-based support to optimise treatment strategies. It will also provide recommendations for integrating these interventions into community-based chronic disease management. METHODS AND ANALYSIS:To identify potentially relevant randomised controlled trials, a reverse search strategy will be employed to ascertain all non-pharmacological interventions for PH. A well-constructed search strategy will be applied across nine academic databases (Web of Science, Embase, PubMed, PsycINFO, CENTRAL, AMED, CNKI, WF and VIP database) and three clinical trial registries (WHO ICTRP, ClinicalTrials.gov and ChiCTR) for studies conducted between 1 January 2014 and 1 August 2024. Two investigators will independently extract information from eligible articles and document reasons for exclusions. The primary outcomes will encompass changes in systolic and diastolic BP. Pairwise and Bayesian NMA will be conducted using 'meta' and 'GeMTC' package (R 4.4.1). Risk of bias will be assessed using the Risk of Bias 2 tool, and the quality of evidence will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION:As this review involves secondary analysis of previously published data, ethical approval is not required. The results will be published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER:CRD42023451073.

OBJECTIVE:This study investigated the neural mechanisms underlying appetite dysregulation in female subjects with abdominal obesity (AO) by identifying functional connectivity (FC) and network-level differences between moderate appetite (MA) and strong appetite (SA) subtypes. METHODS:A total of 60 women with AO (30 MA, 30 SA) and 30 healthy controls (HCs) underwent resting-state fMRI. Independent component analysis was used to identify and examine FC within and functional network connectivity (FNC) between key resting-state networks, including those involved in cognitive and visual processing. Network alterations and correlations with obesity-related indicators were evaluated. RESULTS:Compared to HCs, both groups showed reduced FC in the default mode network (DMN) and visual network (VN), with SA additionally exhibiting decreased FC in the frontoparietal network (FPN) and lower angular gyrus FC than MA (p < 0.05, FDR-corrected). MA displayed increased DMN-left FPN (FPN_L) FNC (p < 0.001), while SA showed negative correlations between FC and BMI/appetite visual analog scale (VAS) scores in FPN and with body weight/BMI/appetite VAS in VN (p < 0.05). In HCs, DMN-FPN_L FNC positively correlated with BMI, a pattern that was not observed in MA. CONCLUSION:Distinct brain network patterns characterize appetite subtypes in AO. SA showed more pronounced FC reductions in networks previously linked to self-regulation and visual processing, which may contribute to appetite dysregulation based on correlations with obesity indicators. In contrast, MA exhibited increased DMN-FPN_L FNC, potentially reflecting adaptive internetwork interactions.

Negative symptoms in treatment-resistant schizophrenia (TRS) are notably persistent and minimally affected by antipsychotics, the transcutaneous auricular vagus nerve stimulation (taVNS) is a promising treatment approach. However, clinical trials are scarce, and further efficacy data are needed. We conducted a double-blind, sham-controlled, randomized clinical trial to determine the efficacy and safety of taVNS as an add-on treatment for patients with TRS with predominantly negative symptoms and to investigate potential biomarkers of efficacy. A total of 50 patients underwent a two-week intervention of active taVNS (n = 25) or sham taVNS (n = 25), followed by a two-week follow-up. Primary outcome was the change in the PANSS-factor score for negative symptoms (PANSS-FSNS) assessed after the intervention. In the intention-to-treat analysis, patients receiving active taVNS showed a significantly greater improvement in negative symptoms compared with those receiving the sham procedure (PANSS-FSNS difference, -1.36; effect size, -0.62; 95% CI, -1.20 to -0.04; p = 0.033), with effects sustained at follow-up and good tolerability. Inflammatory cytokines and EEG coherence showed that in the active group, the change in PANSS-FSNS scores after treatment was significantly correlated with changes in tumour necrosis factor (TNF)-α (r = 0.56, corrected p = 0.017) and beta-band coherence between the left frontal and parietal regions (r = -0.56, p = 0.004), but not in the sham group. This study suggests that taVNS may effectively and safely ameliorate negative symptoms in TRS, with TNF-α and beta-band coherence between the left frontal and parietal regions as potential sensitivity efficacy biomarkers. Chinese Clinical Trial Registry ( http://www.chictr.org.cn .), ChiCTR2400085198.

IntroductionMotor dysfunction, including bradykinesia, rigidity, tremor, and gait disturbance, is the core clinical feature of Parkinson’s disease (PD) and a major cause of disability. In early-stage PD (Hoehn and Yahr ≤2.5), neurodegeneration is relatively mild, and timely intervention may help preserve motor function and delay progression. Although dopaminergic medications effectively alleviate motor symptoms, their long-term use is associated with motor fluctuations and levodopa-induced dyskinesia. Acupuncture, a low-risk, well-tolerated intervention, has shown potential in improving motor performance in PD, but high-quality evidence in early-stage patients is lacking.Methods and analysisThis single-blind, sham-controlled randomized clinical trial will enroll 120 patients with early-stage PD (disease duration ≤3 years). Participants will be randomly assigned in a 1:1 ratio (n = 60 per group) to the true acupuncture (TA) or sham acupuncture (SA) group using stratified block randomization (block size 4) by study center. Treatment will be administered three times weekly for 12 weeks, with follow-up to 15 months. The primary outcome is the change in composite clinical motor score (CCMS) from baseline to week 12. The secondary outcomes include Movement Disorder Society unified Parkinson’s disease rating scale (MDS-UPDRS), Purdue Pegboard Test score (PPTS), Timed Up and Go Test (TUG), 6-min walk test (6MWT), Non-Motor Symptoms Scale (NMSS), 39-item Parkinson’s Disease Questionnaire (PDQ-39), Clinical Global Impression Scale (CGI), and levodopa equivalent daily dose (LEDD). Acupuncturists will not be blinded while participants, outcome assessors, and data analysts remain blinded. The primary analysis will use intention-to-treat (ITT) with mixed-effects models for longitudinal changes, handling missing data via multiple imputation by chained equations.DiscussionThis study aimed to evaluate the efficacy and safety of acupuncture in improving motor function in early-stage PD. The results will help determine its potential role as an adjunctive therapy to preserve motor function.Clinical trial registrationhttps://itmctr.ccebtcm.org.cn/, identifier ITMCTR2025001290.

Objective:Perimenopausal insomnia (PMI) significantly compromises the quality of life and the physical and mental wellbeing of perimenopausal women. Although many randomized controlled trials (RCTs) indicate that acupuncture alleviates PMI symptoms, comprehensive evidence on its efficacy and safety is lacking. We conducted a meta-analysis to systematically evaluate the therapeutic efficacy and safety of acupuncture for PMI, aiming to provide robust, evidence-based guidance for clinical practice. Methods:A total of 12 trials were included in the study, involving 499 participants in the acupuncture group and 495 in the control group, all of which provided data for the meta-analysis. Quality assessment was performed using the Cochrane Risk of Bias (ROB) tool. RevMan version 5.4 and Stata 18.0 software were used for meta-analysis and sensitivity analysis. Results:A total of 10 studies were included, with the random-effects model showing that acupuncture significantly improved sleep quality compared to the drug control group, as evidenced by a reduction in Pittsburgh Sleep Quality Index (PSQI) scores [mean difference (MD) = -2.26, 95% confidence interval (CI) (-4.23 to -0.29), p < 0.00001]. Subgroup analyses revealed that acupuncture outperformed Estazolam (MD = -2.89, p < 0.00001). However, it did not outperform alprazolam (MD = -2.30, p = 0.27) or diazepam (MD = -6.55, p < 0.00001). Compared to sham acupuncture, acupuncture resulted in a significantly greater reduction in PSQI scores (MD = -4.85, p = 0.0001). Acupuncture also led to reductions in luteinizing hormone (LH) (MD = -6.55, p < 0.00001) and follicle-stimulating hormone (FSH) (MD = -12.12, p = 0.002), and an increase in estradiol (E2) levels (MD = 11.96, p < 0.00001). One study reported a significant improvement in Insomnia Severity Index (ISI) scores (MD = -3.64, p = 0.0003). Adverse event data were reported in only 4 of the 12 studies. Conclusion:Current evidence of low to moderate quality suggests that acupuncture may offer potential benefits and demonstrate good safety for PMI. However, these findings require further validation through large-scale, multicenter, double-blind RCTs using standardized protocols. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, Identifier (CRD42018092917).

Abdominal obesity (AO) exhibits unique endocrine and metabolic characteristics in women, yet its neural mechanisms remain unclear. The aim of this study was to investigate the neural mechanisms of AO in females by examining functional connectivity (FC) alterations across brain networks. Resting-state functional MRI (rs-fMRI) data were collected from 38 female AO patients and 24 healthy controls (HCs). Independent component analysis (ICA) was utilized to evaluate FC and functional network connectivity (FNC) within and between brain networks. FC analysis revealed significant alterations within the default mode network (DMN), ventral attention network (VAN), and visual network (VN) (p < 0.05, FDR corrected). In the DMN, increased FC was observed in the left posterior cingulate gyrus and left angular gyrus, while decreased FC was found in the left precuneus and right posterior cingulate gyrus. The VAN and VN showed reduced FC in regions associated with attention control and visual processing, including the left inferior parietal gyrus, left inferior frontal gyrus, triangular part, and left calcarine fissure and surrounding cortex. Internetwork analysis identified significantly higher FNC between the DMN and left frontoparietal network in female AO patients (p < 0.001). This study revealed significant abnormalities in brain functional connectivity in female AO patients, particularly in networks related to self-referential processing, attention, and decision-making. These findings provide a neural basis for cognitive and emotional dysregulation in AO and highlight the potential for targeted interventions to improve self-regulation and inform prevention and treatment strategies.

Purpose:Acute lateral ankle sprain (ALAS) is a prevalent clinical sports injury disease, rapid relief of symptoms and return to normal functional activity are urgent needs of ALAS patients. The aim of this study is to observe the immediate therapeutic effect of acupuncture on ALAS patients in the short term and to evaluate the efficacy at different time points through a multidimensional assessment system, which is expected to provide a simple, rapid, safe and effective therapeutic option for ALAS patients. Patients and Methods:This is a single-center, prospective, randomized clinical trial. About 177 eligible ALAS patients will be randomly assigned in a 1:1:1 ratio to the Group A, Group B and Group C. All three groups of patients will be professionally instructed to move their ankle joints in different directions. Group A will receive real acupuncture treatment and Group B will receive sham acupuncture treatment. Each group will receive one treatment of 10 minutes. Planned Outcomes:The primary outcome is the change in pain intensity 10 minutes after treatment compared to before treatment, measured using the visual analog scale (VAS). Secondary outcomes will include pain VAS scores at 0, 1, 3 minutes of treatment; Range of motion (ROM) scores for ankle joint mobility and changes in Infrared Thermography (IRT) of the area of ankle pain at 0, 1, 3, 10 minutes of treatment. Other outcomes include the blinding assessment, the expected treatment effect assessment, and the rescue analgesia rate. The statistical analysis of this trial will be performed using SPSS software. Conclusion:The results of this study may provide evidence-based medical evidence for the treatment of ALAS with acupuncture, and it is expected that the findings of this study will provide a simple, rapid, safe and effective treatment option for patients with ALAS.

OBJECTIVE:Acupuncture is recognized as an effective migraine treatment, but the comparative long-term efficacy of different acupuncture methods at identical acupoints remains unclear. This study investigates the prophylactic effects of manual acupuncture (manual penetrating acupuncture, MPA) versus sham acupuncture (non-penetrating acupuncture, NPA) at the same acupoints. METHODS:In this multicenter, single-blind randomized controlled trial conducted across four Chinese clinical centers (May 2020 to September 2022), 192 migraineurs without aura (International Classification of Headache Disorders 3rd edition criteria) were randomized 1:1 to 12 sessions of MPA or NPA. Primary outcome was the change from baseline in migraine attack frequency at week 16; secondary outcomes included migraine attack frequency, responder rates, migraine days, and pain intensity (every 4 weeks), etc. Trial registration: No. ChiCTR2000032308. RESULTS:A total of 198 participants were randomly allocated to either MPA or NPA groups, 99 in each group. At 16 weeks, the change in MPA showed a greater reduction in migraine attacks versus NPA (mean difference [MD] = -0.6, 95% confidence interval [CI] -1.5 to 0.05; p = 0.069). MPA demonstrated superior responder rates (risk difference = 17.2%, 95% CI 5.2 to 29.1; p = 0.007) and pain reduction (MD = -0.6, 95% CI -1.1 to -0.2; p = 0.003) after treatment. At follow-up, MPA improved all migraine symptoms and some quality of life compared with NPA. Adverse events occurred in 5.1% of MPA participants. CONCLUSIONS:Although MPA and NPA showed comparable preventive effects, MPA provided sustained symptom relief and quality-of-life improvements. Therefore, suitable acupoint selection establishes therapeutic potential, whereas acupuncture methods critically determine long-term clinical benefits.

Postoperative patients with hip fractures (HFs) frequently experience severe pain, swelling, and restricted mobility in the affected joint, substantially compromising their quality of life. As a non-pharmacological intervention, acupuncture has shown promise in supporting rehabilitation following various fractures, a notion corroborated by a growing body of clinical research. Therefore, this study aims to systematically assess the efficacy and safety of acupuncture in promoting postoperative recovery among patients after HF surgery. The study will randomly divide 244 patients into either the acupuncture group or the sham acupuncture group with an allocation ratio of 1:1. All patients will receive four treatments within a one-week period and a follow-up evaluation one month after the treatment course. The primary outcome will be measured using the Harris Hip Score (HHS). Secondary outcomes will include the Visual Analog Scale (VAS), the Self-Rating Depression scale (SDS), the Self-Rating Anxiety scale (SAS), the lower extremity swelling scale, levels of inflammatory factor level (IL-2, IL-6, TNF-α), the Short Form 36 Health Survey (SF-36), rate of remedial analgesia, the blinded assessment, and the treatment expectations scale. Safety will be assessed throughout the trial. All results will be analyzed following the intention-to-treat principle. This prospective trial will provide high-quality evidence for evaluating the effectiveness and safety of acupuncture in postoperative recovery from HF, and the results may provide new options for clinical treatment. ClinicalTrials.gov Identifier: ITMCTR2025001644.