ETHNOPHARMACOLOGICAL RELEVANCE:Moxibustion, a traditional Chinese healing method, uses mugwort (Artemisia argyi H.Lév. & Vaniot) to apply heat to specific points, treating conditions like "Bi Zheng", which is akin to rheumatoid arthritis (RA). According to traditional theory, its therapeutic actions are attributed to warming the meridians and regulating the flow of Qi and blood. AIM OF THE STUDY:To quantitatively evaluate the therapeutic efficacy of moxibustion and to map its anti-arthritic mechanisms in animal models of RA. MATERIALS AND METHODS:The protocol was registered with PROSPERO (CRD42024503829) and reported according to PRISMA 2020. Eight databases were searched through 28 July 2025 for randomized controlled animal studies comparing moxibustion with the control in RA models. The primary outcome was arthritis severity, assessed by the arthritis index, paw volume, and histopathological score. Secondary endpoints included serum or tissue levels of pro-inflammatory cytokines (IL-1β, TNF-α, IL-6), immunomodulatory cytokines (IL-10, IL-4), and key signaling proteins (NF-κB, NLRP3, TLR4, MyD88). The SYRCLE tool was used to assess the risk of bias. RESULTS:Seventy-three studies were included. Meta-analysis showed that moxibustion significantly reduced arthritis severity (arthritis index: SMD -3.72, 95% CI -4.25 to -3.20; paw volume: SMD -4.59, 95% CI -5.54 to -3.63; histopathological score: SMD -2.24, 95% CI -2.80 to -1.67). Moxibustion also lowered the levels of pro-inflammatory cytokines: IL-1β (SMD -3.52, 95% CI -4.19 to -2.86), IL-6 (SMD -3.17, -4.17 to -2.16), and TNF-α (SMD -3.38, -3.97 to -2.79) and suppressed key signaling pathways, including NF-κB (SMD -2.29, 95% CI -3.20 to -1.37), NLRP3 (SMD -1.74, 95% CI -2.49 to -0.99), TLR4 (SMD -6.72, 95% CI -12.54 to -0.90), and MyD88 (SMD -9.16, 95% CI -15.28 to -3.04). CONCLUSION:This meta-analysis suggests that moxibustion alleviates arthritis severity and histopathological damage in RA animal models, potentially through modulating inflammatory networks and inhibiting key pathways such as NF-κB and NLRP3. These findings provide preclinical evidence supporting the rationale for future clinical investigation of moxibustion as a potential adjunct therapy for RA.

BACKGROUND:Gut microbiota is considered as a new target for the treatment of rheumatoid arthritis (RA). However, the mechanism by which Sinomenine (SIN) alleviates RA by modulating gut microbiota has not been fully explored. METHODS:The collagen-induced arthritis (CIA) rat model was established, and the therapeutic effect of SIN on CIA rats was evaluated. Alterations in gut microbiota and serum metabolites in CIA rats after SIN administration were assessed by 16S rRNA and non-targeted metabolomics methods. Then the CIA pseudo-sterile model was established by the combination of broad-spectrum antimicrobials (ATMs). The therapeutic effect, gut microbiota, and serum metabolites of SIN on CIA-ATM rats was investigated. RESULTS:SIN significantly increased body weight, alleviated arthritis index, paw swelling, and ankle joint pathological changes, and reduced serum levels of pro-inflammatory cytokines interleukin (IL) -1beta, IL-6, IL-17 A, IL-18, and tumor necrosis factor (TNF)-alpha, and increased IL-10 in CIA rats in a dose-dependent manner. The composition of the gut microbiota was optimized after SIN was utilized. SIN regulated the serum metabolism of bile acids, glycerophospholipids, and fatty acids in CIA rats, thereby exerting anti-arthritis effects. In addition, SIN did not affect the arthritis-related indicators of CIA-ATM rats. Furthermore, SIN treatment did not significantly restore the diversity of gut microbiota in CIA-ATM rat. Meanwhile, SIN administration had no beneficial regulatory effect on the serum metabolome of CIA-ATM rats. CONCLUSIONS:SIN exerts anti-arthritis effects, at least in part, by regulating the gut microbiota. Targeting the gut microbiota may be a future therapeutic strategy for RA management.

Objective Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint destruction and high disability rates. Moxibustion, a traditional Chinese medicine therapy with a long history of use in RA management, has attracted increasing clinical attention. Although previous studies have explored the mechanisms underlying the efficacy of moxibustion in RA, its lipidomic mechanisms remain unclear. Therefore, this study aimed to elucidate the lipidomic mechanisms of moxibustion by integrating broad-spectrum targeted lipidomics and eicosanoid-targeted lipidomics to identify key lipid metabolites associated with its therapeutic effects. Methods Thirty-two male Sprague–Dawley rats were randomly assigned to four groups (n = 8 per group): control, model, moxibustion control, and moxibustion model groups. The collagen-induced arthritis (CIA) model was established by two rounds of immunization. Moxibustion was applied bilaterally at “Zusanli (ST 36)” and “Shenshu (BL23)” for 10 minutes per acupoint (40 minutes per session). Treatment was administered once daily for six consecutive days per cycle, for three cycles, with a one-day interval between cycles. After three weeks of treatment, therapeutic effects were evaluated based on body weight, paw volume, arthritis index (AI) score, visceral indices, and histopathological examination. Serum lipid profiles were analyzed to identify differential metabolites and metabolic pathways associated with moxibustion. Results Compared with the control group, rats in the model group exhibited poor general condition, significant body weight loss, and marked increases in paw volume and AI score (P < 0.05), as well as significantly elevated visceral indices (P < 0.05). In contrast, moxibustion treatment significantly improved general condition, restored body weight, and reduced paw volume, AI score, and visceral indices compared with the model group (P < 0.05). Histopathological examination revealed marked synovial hyperplasia, inflammatory cell infiltration, and cartilage destruction in the ankle joints of the model group, whereas these pathological changes were significantly alleviated by moxibustion. Lipidomic analysis identified 81 differential metabolites between the model and control groups, and moxibustion ameliorated disruptions in the arachidonic acid (ARA) and linoleic acid (LA) pathways. Broad-spectrum targeted lipidomics showed that moxibustion regulated 19 lipid species. Eicosanoid-targeted profiling further demonstrated that, under pathological conditions, moxibustion modulated eight of these lipids to attenuate proinflammatory mediators, whereas under physiological conditions, it adjusted six lipids to maintain lipid homeostasis. Conclusion CIA rats exhibited significant disturbances in lipid metabolism, mainly involving the ARA and LA pathways. Moxibustion effectively regulated broad-spectrum lipid classes and specific eicosanoid mediators, thereby alleviating inflammation under pathological conditions and contributing to physiological homeostasis.

Aim This study was conducted to evaluate the effect of the educational impact of amalgamating the presentation-assimilation-discussion (PAD) and Bridge-in, Objective, Preassessment, Participatory learning, Postassessment, and Summary (BOPPPS) teaching models within the health assessment curriculum. Background For nursing students, developing expertise in physical examination is essential and hinges on their ability to integrate substantial theoretical knowledge with sharp clinical diagnosis. At the novice stage, the students confront the challenge of integrating a vast spectrum of multidisciplinary concepts, often leading to learner burnout. The breadth and intricacy of diseases further complicate teaching efficacy. Design This study has a randomized controlled design. Methods We assessed 274 nursing undergraduates from Nanjing University of Chinese Medicine, allocating them into a control group, which followed conventional teaching practices, and an experimental group immersed in the PAD and BOPPPS methodologies. Comparative analyses of chapter test scores, group report evaluations, and survey responses were conducted using an unpaired student's t-test. Results Notably, the experimental cohort outperformed the control group in chapter tests and group reports (p < 0.05). Additionally, they showcased superior self-directed learning and critical thinking skills, as indicated by the survey (p < 0.05). Conclusions The novel integration of PAD and BOPPPS teaching frameworks in health assessment courses significantly benefits nursing students' academic performance and cultivates their self-learning and critical thinking faculties. (c) 2025 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

AIM:To compare the effectiveness of auriculotherapy in managing nausea and vomiting caused by platinum-based chemotherapy METHODS: 96 patients with gastrointestinal cancer undergoing platinum chemotherapy were randomly divided into three groups, with 32 patients in each group. The control group received conventional treatment, including 5-hydroxytryptamine 3 receptor antagonist and routine nursing care; the remaining two groups received additional auricular point sticking or ear scraping. The outcomes measured included the incidence and frequency of acute and delayed nausea and vomiting, severity of nausea, appetite, and quality of life function index 24 h and 5 d post chemotherapy. RESULTS:Statistically significant differences were observed in the incidence and frequency of acute and delayed nausea and vomiting, severity of nausea, appetite, and life function index of nausea and vomiting at 24 h and 5 d post chemotherapy (P < 0.05); the efficacy of treatment in the ear scraping and auricular point sticking groups was better than that of the control group (P < 0.05). Moreover, the ear scraping group experienced a more effective reduction in acute nausea and vomiting than that in the auricular point sticking group (P < 0.05), and auricular point sticking showed better results in managing delayed nausea and vomiting and improving appetite and quality of life 5 d post chemotherapy (P < 0.05). CONCLUSIONS:Auricular point sticking and ear scraping effectively treat chemotherapy-induced nausea and vomiting (CINV). Ear scraping is more effective for acute CINV, whereas auricular point sticking is more effective for delayed CINV, with the distinct advantages of enhancing appetite and quality of life for each type of CINV.

This study aims to evaluate the efficacy of compression therapy in preventing oxaliplatin-induced peripheral neuropathy (OIPN) in colorectal cancer patients. Colorectal cancer patients scheduled for their first oxaliplatin-based chemotherapy were randomly assigned to a compression therapy group or a control group. The control group received standard care, while the compression therapy group wore grade II (23–32 mmHg) compression sleeves and socks from 30 min before to 30 min after oxaliplatin infusion. Sensory and motor neuropathy incidence and symptom burden were assessed using physician evaluations and patient self-reports. Adverse events during the treatment period were also recorded. After four cycles, the compression therapy group had a significantly lower incidence of grade ≥ 2 sensory and motor neuropathy compared to the control group (sensory: 41.4

OBJECTIVE:To systematically evaluate the effects of physical exercise on bone mineral density (BMD) in older adults and to explore the potential underlying mechanisms. METHODS:A meta-analysis was conducted through a systematic search of randomized controlled trials (RCTs) published up to May 14, 2025, in Web of Science, PubMed, and the Cochrane Library. The study adhered to PRISMA 2020 guidelines to ensure rigorous literature screening and methodological transparency. Included studies underwent strict quality assessment, with primary outcomes focusing on BMD and related physiological parameters, and secondary outcomes including fall rates and quality of life (QoL) scores. Data were analyzed using Stata 14.0 and RevMan 5.4, encompassing 14 RCTs involving 1219 participants with age-related low BMD. RESULTS:Compared to control groups, exercise interventions significantly increased BMD at the femoral neck, total femur, and trochanter. Additionally, improvements were observed in QoL scores and reductions in fall rates, while other indicators remained unchanged. These findings suggest that exercise has a positive impact on skeletal health and functional outcomes in older adults with low BMD. CONCLUSION:Exercise demonstrates beneficial effects in managing low BMD among older adults, improving bone density, physical function, and overall quality of life. Potential underlying mechanisms include increased mechanical loading, modulation of myokine secretion, enhanced bone metabolism, and regulation of osteocytic autophagy. These findings support the use of exercise as a non-pharmacological strategy for preventing and treating osteopenia and osteoporosis in aging populations.

AIM:This systematic review assesses AI's application, effectiveness and impact on nursing education, while identifying research limitations. BACKGROUND:AI integration in nursing education is transforming traditional teaching and learning paradigms. DESIGN:A systematic review. METHODS:Following PRISMA 2020 guidelines, a search was conducted in PubMed, Web of Science, Embase, Cochrane Library and CINAHL from the inception of the databases to November 1, 2024, focusing on "Artificial Intelligence" and "nursing education." Two reviewers independently screened and assessed the literature. The quality was assessed using the Cochrane Risk of Bias 2.0 (RoB-2) tool for randomized controlled trials (RCTs), the Agency for Healthcare Research and Quality (AHRQ) tools evaluation for observational studies and the JBI Critical Appraisal Checklist for quasi-experimental studies. RESULTS:Fifteen studies involving 1464 nursing students and professionals were included. The application scenarios of AI technology in nursing education are diverse and varied and it has shown significant potential in many areas of nursing education, but conflicting results have also been observed. Evaluation of literature quality showed that there were seven high-quality studies and eight medium-quality studies. Artificial intelligence was found to have a positive impact on students at three levels: learning attitude and psychological effects, learning effectiveness and comprehensive clinical nursing competencies. Key research gaps were identified, including the lack of longitudinal studies, uneven study populations and the lack of measurement instrument validity and objectivity. CONCLUSION:AI positively impacts nursing education but requires further research to address gaps and ensure long-term effectiveness and privacy protection. REGISTRATION:PROSPERO ID: CRD42024562849.

Objective To reveal the therapeutic effects of moxibustion in collagen-induced arthritis(CIA)rat models using the combined analysis of plasma and synovial membrane lipidomic profil-ing and to enhance the understanding of how moxibustion affects lipid metabolism in rheumatoid arthritis(RA). Methods A total of 32 male Sprague-Dawley(SD)rats were randomly assigned to four groups:control,moxibustion control(MC),model,and moxibustion model(MM)groups,with 8 rats in each group.CIA was induced in SD rats by two immunizations.The paw volume was mea-sured before the induction of CIA.Following induction,after assessing paw volume and arthritis index(AI)scores,the MC and MM groups received treatment at bilateral Shenshu(BL23)and Zusanli(ST36)acupoints for 10 min per acupoint.The intervention included three treatment courses,each spanning 6 d and followed by a 1-d interval.Paw volume and AI scores were assessed after each treatment course.After the completion of the three treatment courses,serum,plasma,synovial tissue,and ankle joint samples were collected.Enzyme-linked immunosorbent assay(ELISA)was employed to quantify the levels of interleukin(IL)-6 and tumor necrosis factor(TNF)-α in serum.Hematoxylin and eosin(HE)staining was per-formed for histopathological examination of the ankle joint tissues.Meanwhile,ultra-high-performance liquid chromatography coupled with Q-Exactive Orbitrap mass spectrometry(UHPLC-Q-Exactive Orbitrap MS)was utilized to analyze the plasma and synovial tissue sam-ples.In addition,multivariate statistical analysis was performed to identify differential lipid metabolites,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis was applied to explore metabolic pathways modulated by moxibustion therapy. Results No significant difference in hind paw volume and AI scores was observed among the groups(P>0.05).After CIA induction,model group showed increased hind paw volume and AI scores compared with control group(P<0.05),which were significantly reduced after mox-ibustion treatment in MM group compared with model group(P<0.05).The levels of IL-6 and TNF-α were significantly higher in model and MM groups compared with control group(P<0.05),but were lower in MM group than those in model group(P<0.05).Histopathologi-cal analysis showed improved cartilage and reduced inflammation in MM group.A total of 33 differential lipid metabolites in the plasma and 24 in the synovial membranes of CIA rat mod-els were identified when compared with control group.Among these lipid metabolites,31 in the plasma and all 24 in the synovial membranes were regulated by moxibustion treatment.Pathological analysis revealed upregulation of diacylglycerol(DG)and fatty acid(FA)levels,alongside downregulation of lysophosphatidylcholine(LPC),phosphatidylcholine(PC),and phosphatidylethanolamine(PE).Under physiological conditions,the treatment specifically reduced LPC and PC levels.Pathway enrichment analysis revealed that moxibustion predom-inantly affected α-linolenic acid,glycerophospholipid,and sphingolipid metabolism under pathological conditions.Under physiological conditions,the regulation was centered around α-linolenic acid and glycerophospholipid metabolism. Conclusion The RA rat models exhibited significant lipid metabolic disturbances.Moxibus-tion alleviated paw swelling,reduced AI scores,modulated inflammatory cytokine levels,and partially corrected the altered levels of multiple lipid metabolites.The potential metabolic pathways implicated in the regulation of lipid metabolism under both physiological and pathological conditions include α-linolenic acid,glycerophospholipid,and sphingolipid metabolism.

Introduction Rheumatoid arthritis (RA) is a highly prevalent chronic autoimmune disease worldwide. Moxibustion has increasingly been used in clinical practice as an effective treatment for RA. However, more comprehensive evidence is needed to determine optimal moxibustion strategies for RA management and guide clinical interventions. Methods This review conducted a literature search across eight databases, including PubMed, Embase, Web of Science, Cochrane Library, VIP, CBM, Wanfang Database, and CNKI. The Cochrane Risk of Bias tool 2 was used to assess the quality of the selected studies. Network meta-analysis (NMA) was conducted using R Studio 4.2.2 and STATA 17.0. Results A total of 78 clinical trials with 5896 participants were included. The relative efficacy of nine moxibustion therapies was assessed. NMA data revealed that compared with conventional therapy (CVT, including Disease-modifying Antirheumatic Drugs, Nonsteroidal Anti-inflammatory Drugs, and glucocorticoids), heat-sensitive moxibustion plus CVT showed promising effects for clinical response (RR = 1.45, 95 % CI: 1.08, 2.06) and disease activity score 28 (DAS-28; mean difference [MD] = −0.98, 95 % CI: −1.81, −0.15). Moxa cone moxibustion (MCM) plus CVT was more effective than suspending moxibustion plus CVT in DAS-28 (MD = −0.48, 95 % CI: −0.83, −0.09). For the visual analog scale, MCM plus CVT was the most effective (MD = −1.59, 95 % CI: −2.08, −1.11), more effective than warm needle moxibustion (WNM) plus CVT (MD = −0.93, 95 % CI: −1.81, −0.05) and direct moxibustion plus CVT (MD = −1.49, 95 % CI: −2.81, −0.19). Indirect moxibustion (IM) plus CVT was most effective in reducing morning stiffness time (MD = −22.76, 95 % CI: −36.31, −7.23). WNM plus CVT and governor vessel moxibustion (GVM) plus CVT showed greater effects in reducing swollen joint count (MD = −2.37, 95 % CI: −3.23, −1.54) and lowering rheumatoid factor (MD = −0.68, 95 % CI: −1.58, 0.22). In reducing C-reactive protein, IM plus CVT was most effective (MD = −6.60, 95 % CI: −9.55, −3.95). GVM plus CVT had the lowest adverse reaction rate (3.33 %). Conclusion This NMA provides robust evidence supporting the combination of multiple moxibustion therapies with traditional RA treatments. Moxibustion may alleviate various RA symptoms. However, longer-term, high-quality, reproducible, multicenter randomized controlled trials with larger sample sizes are necessary to confirm these results and establish optimal treatment strategies.

BackgroundCurrently, there has been observed a significant alteration in the composition of the gut microbiome (GM) and serum metabolites in patients with psoriatic arthritis (PsA) compared to healthy individuals. However, previous observational studies have shown inconsistent results regarding the alteration of gut microbiota/metabolites. In order to shed light on this matter, we utilized Mendelian randomization to determine the causal effect of GM/metabolites on PsA.MethodsWe retrieved summary-level data of GM taxa/metabolites and PsA from publicly available GWAS statistics. Causal relationships between GM/metabolites and PsA were determined using a two-sample MR analysis, with the IVW approach serving as the primary analysis method. To ensure the robustness of our findings, we conducted sensitivity analyses, multivariable MR analysis (MVMR), and additional analysis including replication verification analysis, LDSC regression, and Steiger test analysis. Furthermore, we investigated reverse causality through a reverse MR analysis. Finally, we conducted an analysis of expression quantitative trait loci (eQTLs) involved in the metabolic pathway to explore potential molecular mechanisms of metabolism.ResultsOur findings reveal that eight GM taxa and twenty-three serum metabolites are causally related to PsA (P < 0.05). Notably, a higher relative abundance of Family Rikenellaceae (ORIVW: 0.622, 95% CI: 0.438–0.883, FDR = 0.045) and elevated serum levels of X-11538 (ORIVW: 0.442, 95% CI: 0.250–0.781, FDR = 0.046) maintain significant causal associations with a reduced risk of PsA, even after adjusting for multiple testing correction and conducting MVMR analysis. These findings suggest that Family Rikenellaceae and X-11538 may have protective effects against PsA. Our sensitivity analysis and additional analysis revealed no significant horizontal pleiotropy, reverse causality, or heterogeneity. The functional enrichment analysis revealed that the eQTLs examined were primarily associated with glycerolipid metabolism and the expression of key metabolic factors influenced by bacterial infections (Vibrio cholerae and Helicobacter pylori) as well as the mTOR signaling pathway.ConclusionIn conclusion, our study demonstrates that Family Rikenellaceae and X-11538 exhibit a strong and negative causal relationship with PsA. These particular GM taxa and metabolites have the potential to serve as innovative biomarkers, offering valuable insights into the treatment and prevention of PsA. Moreover, bacterial infections and mTOR-mediated activation of metabolic factors may play an important role in this process.

BackgroundCurrently, the association between the consumption of polyunsaturated fatty acids (PUFAs) and the susceptibility to autoimmune rheumatic diseases (ARDs) remains conflict and lacks substantial evidence in various clinical studies. To address this issue, we employed Mendelian randomization (MR) to establish causal links between six types of PUFAs and their connection to the risk of ARDs.MethodsWe retrieved summary-level data on six types of PUFAs, and five different types of ARDs from publicly accessible GWAS statistics. Causal relationships were determined using a two-sample MR analysis, with the IVW approach serving as the primary analysis method. To ensure the reliability of our research findings, we used four complementary approaches and conducted multivariable MR analysis (MVMR). Additionally, we investigated reverse causality through a reverse MR analysis.ResultsOur results indicate that a heightened genetic predisposition for elevated levels of EPA (ORIVW: 0.924, 95% CI: 0.666–1.283, PIVW = 0.025) was linked to a decreased susceptibility to psoriatic arthritis (PsA). Importantly, the genetically predicted higher levels of EPA remain significantly associated with an reduced risk of PsA, even after adjusting for multiple testing using the FDR method (PIVW–FDR–corrected = 0.033) and multivariable MR analysis (PMV-IVW < 0.05), indicating that EPA may be considered as the risk-protecting PUFAs for PsA. Additionally, high levels of LA showed a positive causal relationship with a higher risk of PsA (ORIVW: 1.248, 95% CI: 1.013–1.538, PIVW = 0.037). It is interesting to note, however, that the effects of these associations were weakened in our MVMR analyses, which incorporated adjustment for lipid profiles (PMV-IVW> 0.05) and multiple testing using the FDR method (PIVW–FDR–corrected = 0.062). Moreover, effects of total omega-3 PUFAs, DHA, EPA, and LA on PsA, were massively driven by SNP effects in the FADS gene region. Furthermore, no causal association was identified between the concentrations of other circulating PUFAs and the risk of other ARDs. Further analysis revealed no significant horizontal pleiotropy and heterogeneity or reverse causality.ConclusionOur comprehensive MR analysis indicated that EPA is a key omega-3 PUFA that may protect against PsA but not other ARDs. The FADS2 gene appears to play a central role in mediating the effects of omega-3 PUFAs on PsA risk. These findings suggest that EPA supplementation may be a promising strategy for preventing PsA onset. Further well-powered epidemiological studies and clinical trials are warranted to explore the potential mechanisms underlying the protective effects of EPA in PsA.

• No significant correlation between genetically predicted β-blockers and the risk of developing psoriasis • European populations with genetic proxies of loop diuretics exhibited an increased risk of psoriasis East • Asians with genetic proxies of loop diuretics exhibited a reduced risk of psoriasis

Postmenopausal osteoporosis is the main cause of fractures in women. Resistance exercise has a positive effect on bone mineral density in postmenopausal osteoporosis patients, but its mechanism is unclear. The purpose of this study was to explore the mechanism of resistance exercise in improving ovariectomized osteoporotic rats based on the transcriptome sequencing technique. Eighteen female Sprague-Dawley rats were randomly divided into the sham-operated group, the non-exercise group, and the resistance exercise group. The rat model of postmenopausal osteoporosis was established by bilateral ovariectomy. Ten weeks after the operation, the resistance exercise group received 2 weeks of adaptive training, and 12 weeks of resistance exercise began in the 13th week. The rats were trained 5 days per week, in 4 sets of 3 repetitions per day. After the intervention, all rats were sacrificed, and the body weight, bone mineral density, trabecular bone microarchitecture, and bone biomechanics were examined. At the same time, RNA-seq and enrichment analysis of gene ontology and Kyoto Encyclopedia of Genes and Genomes were performed on the left tibias, followed by Elisa and RT-qPCR verification. It had been found that resistance exercise can effectively counteract the weight gain of ovariectomized osteoporotic rats, and has a good effect on bone mineral density and trabecular bone microarchitecture. Enrichment analysis showed that regulation of gene expression and osteoclast differentiation is the most closely related biological process and signaling pathway shared by RE/Ovx and NE/Ovx groups. Our results revealed that resistance exercise can play a role in inhibiting osteoclast activation and preventing the enhancement of osteoclast bone resorption function in ovariectomized osteoporotic rats by inhibiting Fos/Fosb-regulated TRAP activation and relieving Calcr inhibition, which has important application value in preventing bone loss caused by estrogen deficiency.

Background and Objective: Moxibustion is effective for low back pain (LBP), and inflammatory cytokines may play an important role in the mechanism of moxibustion treatment. The purpose of this meta-analysis was to explore the mechanism of moxibustion in LBP in terms of inflammatory cytokines. Methods: We searched China National Knowledge Infrastructure, Wanfang database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, PubMed, and Web of Science to identify eligible randomized controlled trials (RCTs). There was no restriction on the publication date. Results: Thirty RCTs measuring interleukin (IL-) 1, IL-1 beta, IL-6, IL-12, IL-17, IL-23, and tumor necrosis factor (TNF-) alpha were included in this meta-analysis. Compared to controls: single moxibustion could effectively decrease levels IL-6 and IL-23 (SMD, -0.71, 95% CI: -1.25 to -0.17, p = 0.01; SMD, -1.61, 95% CI: -2.20 to -1.03, p < 0.01, respectively); combined moxibustion had significant effects on IL-1, IL-1 beta, IL-6, IL-12, IL-17, and TNF-alpha (p < 0.05). Overall, for LBP, single or combined moxibustion could effectively down-regulate levels of pro-inflammatory cytokines (p = 0.007 and p < 0.00001, respectively). For safety of moxibustion, the incidence rate of side effects was similar to that of controls (RD, -0.01, 95% CI: -0.02 to 0.01, p = 0.59). Sensitivity analysis showed that the pooled estimates were robust, and publication bias analysis showed there was a significant small study effect (Egger's test p = 0.0000). High statistical heterogeneity existed between included RCTs, meta-regression showed there was no potential factor explaining the source of heterogeneity. Conclusion: For LBP, moxibustion can effectively decrease levels of IL-1, IL-1 beta, IL-6, IL-12, IL-17, IL-23, and TNF-alpha to achieve analgesia. Because the side effects of moxibustion are transient, it is relatively safe for clinical use. However, based on high heterogeneity in this meta-analysis, rigorously designed RCTs are required to further confirm the results in this review.

Colon adenocarcinoma (COAD) is a prevalent and aggressive form of cancer that necessitates the identification of robust biomarkers for early diagnosis and treatment. Therefore, this project was launched to identify a few key biomarkers from CC and CXC chemokine families for the accurate detection of COAD. Hub gene identification was performed using CytoHubba analysis. Clinical samples from COAD patients and normal individuals were collected and subjected to appropriate methods for DNA and RNA extraction. The expression levels of hub genes were analyzed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), while promoter methylation analysis was conducted using targeted bisulfite sequencing (bisulfite-seq). Additionally, The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets were utilized to validate the findings based on clinical samples. CXCL10 (C-X-C motif chemokine ligand 10), CXCL12 (C-X-C motif chemokine ligand 12), CXCL16 (C-X-C motif chemokine ligand 16), and CCL25 (CC motif chemokine ligand 25) were denoted as the key hubs among CC and CXC chemokine families. Through RT-qPCR analysis, it was found that CXCL10, CXCL12, and CXCL16 were significantly up-regulated, while CCL25 was down-regulated in COAD patients compared to healthy controls. Later on, these findings were also validated using TCGA and GEO datasets consisting of COAD and normal control samples. Furthermore, we investigated the promoter methylation status of these chemokine genes in COAD patients. Our results revealed significant dysregulation of promoter methylation, suggesting an epigenetic mechanism underlying the altered expression of CXCL10, CXCL12, CXCL16, and CCL25 in COAD. In addition to this, various additional aspects of the CCL25, CXCL10, CXCL12, and CXCL16 have also been uncovered in COAD during the present study. This study highlights the dysregulation of CXCL10, CXCL12, CXCL16, and CCL25 chemokine members in COAD patients, emphasizing their significance as potential biomarkers and therapeutic targets in the management of this deadly disease. However, further investigations are warranted to elucidate the underlying molecular mechanisms and evaluate the clinical utility of these findings.

OBJECTIVE: To evaluate the available evidence from randomized controlled trials (RCTs) of moxibustion alone for lumbar disc herniation (LDH) treatment.METHODS: A systematic search of 10 databases (until August 30, 2021) was used to identify studies that reported the response rate, visual analogue scale (VAS) score, Japanese Orthopedic Association (JOA) score, and Oswestry Disability Index (ODI) score. Study selection and data extraction were independently performed by two reviewers. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials. The Grading of Recommendations Assessment, Development, and Evaluation Methodology (GRADE) were also used to test the quality of the result evidence.RESULTS: Nineteen RCTs, including 1888 patients, met the inclusion criteria. Five studies showed no difference between moxibustion and acupuncture on response rate [risk ratio (RR) = 1.07, 95%CI (0.98, 1.16), P = 0.11]. Meanwhile, six studies suggested that there is no significant difference between moxibustion and acupuncture on VAS score [mean difference (MD) = -0.43, 95% CI (-0.91, 0.05), P = 0.08]. Eight studies implied that there is no significant difference between moxibustion and acupuncture on JOA score [MD = 0.84, 95% CI (-1.27, 2.96), P = 0.44]. Two studies indicated that moxibustion may have equivalent effects for treating LDH in the VAS score in comparison with drug therapy [MD = -1.16, 95%CI (- 2.63, 0.31), P = 0.12]. The evidence level of results was determined to be very low to low. CONCLUSIONS: Based on the existing evidence, moxibustion may not be suitable for treating LDH alone, but it may be applied as an adjuvant treatment. Furthermore, well-designed RCTs with high quality and larger samples are still needed to evaluate the efficacy and safety of moxibustion alone for LDH treatment.

Objective To compare the effects of auricular point intradermal needling with auricular point sticking on digestive symptoms and quality of life in patients undergoing platinum-based chemotherapy regimens. Methods Ninety-six patients receiving platinum-based chemotherapy were randomly assigned to three groups using the random number table method, with 32 cases in each group. The control group received conventional nursing care plus 5-hydroxytryptamine receptor antagonist, and the other two groups received additional auricular point intradermal needling or sticking. For the three groups of participants, the acute and delayed vomiting and nausea severity, quality of life, and the additional antiemetic consumption rate were observed. Results The three groups had no significant differences in the acute vomiting frequency and nausea severity and appetite ( P >0.05) but had significant differences in the delayed vomiting frequency and nausea severity ( P <0.05); the auricular point intradermal needling group won over the auricular point sticking group. The three groups showed significant differences in comparing the appetite in the delayed stage ( P <0.05); both auricular point intradermal needling and sticking groups showed advantages over the control group ( P <0.05), but no significant difference existed between the auricular point intradermal needling and sticking groups ( P >0.05). There were significant differences in comparing the functional living index-emesis (FLIE) score in both acute and delayed stages among the three groups ( P <0.05) and the result favored the auricular point intradermal needling group over the auricular point sticking group ( P <0.05). The additional antiemetic consumption rate was higher in the control group than in the other groups ( P <0.05). Conclusion Based on the conventional nursing and 5-hydroxytryptamine receptor antagonist, adding either auricular point intradermal needling or auricular point sticking can lower the vomiting frequency and nausea severity in the delayed stage and improve appetite in patients receiving platinum-based chemotherapy regimen, but they have no notable impact on digestive symptoms in the acute stage; auricular point intradermal needling is superior to auricular point sticking in comparing the overall efficacy. Both auricular point intradermal needling and auricular point sticking can enhance the quality of life in patients undergoing chemotherapy and reduce their additional antiemetic consumption.

The study aimed to explore the prognostic value of fear-avoidance beliefs (FABs) on postoperative pain and back-specific function for patients with lumbar degenerative disk disease (LDDD). FABs have been proven to be a predictorof pain and disability for patients with low back pain. However, whether FABs are a predictor of surgical outcomes for LDDD is a matter of debate. PubMed, Cochrane library, EMBASE, and EBSCO were searched for eligible cohort studies or secondary analyses of randomized controlled trials. Fixed-effect meta-analysis models were used to estimate odds ratios (OR) because of absent or low heterogeneity ( I ² < 50%). Subgroup analyses were conducted according to different follow-up durations. Forest plots were used for graphical representation. Six studies with a total of 829 participants were included in the meta-analyses. Risk of bias was high for three studies and moderate for the other three studies. For patients with LDDD, meta-analyses showed that FABs were a predictor of postoperative pain intensity [OR 2.88; 95% confidence interval (CI), 2.76–3.00] and back-specific function (OR 3.13; 95% CI, 3.02–3.24). Patients with FABs are less likely to report improvement in pain (OR 2.56; 95% CI, 1.73–3.86) and function (OR 2.81; 95% CI, 2.57–3.07). In conclusion, FABs were a predictor of postoperative pain and back-specific function for patients with LDDD. This prognostic value is sustained for a long period after surgery (>12 months). Clinicians are advised to initiate targeted interventions for patients with FABs at different stages after surgery. Due to the limited number and low quality of included studies, the results of this meta-analysis should be interpreted with caution.

Objective: The aim of this study was to evaluate the effect of electroacupuncture (EA) combined with medication on clinical efficacy, pain scores (Visual Analogue Scale, [VAS]), Disease Activity Score in 28 joints (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and adverse events in treating patients with rheumatoid arthritis (RA). Methods: A systematic search of PubMed, the Cochrane Library, Web of Science, Embase, SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP until December 12, 2021 was used to identify randomized controlled trials (RCTs) on the EA treatment of RA. Study selection and data extraction were performed critically and independently by two reviewers. Cochrane criteria for risk of bias was used to evaluate the methodological quality of the trials. The Grading of Recommendations Assessment, Development, and Evaluation Methodology (GRADE) was applied to assess the quality of evidence from quantitative analysis. Results: Seventeen RCTs, including 1317 patients, satisfied the inclusion criteria. Compared with the control group, EA combined with medication had a superior effect on clinical efficacy (RR = 1.25 [95% CI = 1.18 to 1.33], P < 0.00001), VAS score (MD = -1.34 [95% CI = -1.90 to -0.78], P < 0.00001), DAS28 (MD = -0.76 [95% CI = -1.08 to -0.44], P < 0.00001), CRP level (SMD = -1.46 [95% CI = -2.19 to -0.74], P < 0.0001), and ESR (MD = -7.74 [95% CI = -13.77 to -1.72], P = 0.01). Compared with the control group, the meta-analysis showed no significant changes in adverse events in the EA group (RR = 1.08 [95% CI = 0.51 to 2.25], P = 0.85). The evidence level of the results from the 17 studies was very low to moderate. Conclusions: EA combined with medication showed a superior effect than Western medicine alone in clinical efficacy, VAS, DAS28, CRP, and ESR. The clinical safety of EA warrants further investigation in experimental studies.