How acupuncture works is of significant scientific value and strategic importance in life sciences. The efficacy of acupuncture has been validated in clinic for millennia and has been widely recognized globally. The effects of acupuncture involve complex, multilevel, and multi target biological processes, including the regulation of neural reflex pathways, release of endogenous substances, and remodeling of immune regulatory networks. However, previous research has predominantly focused on the molecular basis of signal transduction, neural coding principles, and systemic effects on bodily homeostasis, while overlooking a core element of the mechanical signals generated by acupuncture. Accordingly, we propose establishing acupuncture bomechanics as a new interdisciplinary discipline. This paper aims to systematically elucidate how acupuncture-induced mechanical stimuli propagate through biological tissues, how distinct cell populations mechanotransduce these signals, and the resulting systemic biological effects. Focusing on the mechanical signals generated by acupuncture manipulation, we analyze the spatiotemporal distribution of mechanical parameters as the basis for investigation. To this end, we seek to establish a quantitative characterization system and a cross-scale integration model to rigorously analyze acupuncture mechanics. This mode of investigation includes the standardization of parameters for mechanical action, the modeling of acupuncture dose-effect relationships, and the mechanistic analysis of individual variability. By employing the characteristic spectrum of mechanical signals to predict therapeutic efficacy and refine manipulation strategies, the overarching goal is to establish acupuncture treatment protocols that are quantifiable, and verifiable. The development of acupuncture biomechanics as a discipline would offer a novel mechanical perspective on the mechanisms underlying acupuncture effects, catalyzing theoretical advancements that modernize acupuncture, and then pave the way for innovative theoretical frameworks in medicine and transformative shifts in clinical treatment paradigms.

BackgroundRecent studies suggest a link between immune-related processes and type 2 diabetes (T2DM), yet the specific genes and mechanisms remain unclear. This study aimed to explore the mechanistic relationship by integrating multi-omics data.MethodsWe identified T2DM-associated candidate genes through summary data-based Mendelian Randomization (SMR) and colocalization analyses using immune-related QTL data and large-scale GWAS data. We then functionally validated key genes in a high-fat diet-induced T2DM mouse model, assessing gene expression and the therapeutic effects of electroacupuncture (EA) using RT-qPCR.ResultsSMR and colocalization analyses identified PLXNB2 and LTBP3 as core candidate genes associated with T2DM. In the T2DM mouse model, we not only confirmed the abnormal expression of Plxnb2 and Ltbp3 but also observed coordinated changes in key upstream/downstream molecules, such as TGF-β, revealing a functional immune regulatory network. Importantly, EA intervention significantly modulated the expression of the entire network, including Plxnb2, Ltbp3, and TGF-β, confirming their functional relevance.ConclusionsIntegrating large-scale human genetic data with in vivo validation, our study highlights the significance of immune-related genes—particularly LTBP3, PLXNB2, TGF-β, and IgA—in T2DM pathogenesis. The modulation of these genes by EA treatment provides direct evidence for the molecular mechanisms underlying its therapeutic effect on T2DM.

ObjectiveThis study employs a dual-metric framework integrating bibliometric and altmetric analyses to systematically map the knowledge domain and structural evolution of P2Y receptor research in cardiovascular diseases (CVDs) from 2005 to 2025.MethodsData were systematically retrieved from the Web of Science Core Collection, Scopus, PMC, and Altmetric databases. By integrating network visualization (CiteSpace, VOSviewer), descriptive bibliometrics, and qualitative content analysis, this study mapped the structural evolution of the research landscape. Additionally, the correlation between scholarly impact and social visibility was quantified using Spearman analysis.ResultsOur analysis encompassed 2,591 articles published between 2005 and 2025, from which the top 100 based on citation count and Altmetric Attention Score (AAS) were selected. The annual publication volume demonstrates sustained growth. The USA contributed 941 articles and holds a leading position, with scholars such as Dominick J. Angiolillo (132 articles) forming a core collaborative network focused on the clinical translation of P2Y12 antagonists. High-impact journals (Impact Factor >5) accounted for 80% of the publications, indicating a strong clinical orientation; the Journal of the American College of Cardiology received the most citations. The research focus has shifted from the antithrombotic mechanisms of early P2Y12 inhibitors like clopidogrel toward immune inflammation, myocardial regeneration, and precision medicine. Altmetric Attention Scores showed a high correlation with social media attention but only a moderate correlation with academic citations, whereas Mendeley readership correlated strongly with citations, revealing a divergence between social visibility and scholarly impact.ConclusionP2Y receptor research has transformed from a singular antithrombotic focus into a multidimensional regulatory network. While P2Y12 antagonists remain clinically dominant, emerging frontiers focus on “de-escalation” strategies, immune-inflammation, and myocardial regeneration. Future progress relies on systematic evaluation of subtype selectivity and novel delivery systems, positioning P2Y receptor modulation as a promising avenue for precision cardiovascular medicine.

Background Heart failure (HF) is a clinical syndrome characterized by impaired cardiac diastolic and systolic function due to structural or functional damage to the myocardium. HF represents the end-stage manifestation of many cardiac diseases. Therefore, early identification of high-risk patients is crucial. This study aims to utilize machine learning (ML) methods to develop and validate a model to predict major adverse cardiovascular and cerebrovascular events (MACCE) in patients with HF and identify its key predictive features.Methods This study is a retrospective cohort study. We enrolled a total of 271 patients, who were divided into training and testing sets. Baseline data, including cardiopulmonary exercise testing (CPET) parameters and laboratory tests, were collected for all participants. Based on the presence or absence of MACCE during follow-up, they were categorized into a No-event group and MACCE group. We developed seven ML models to predict the incidence of MACCE in patients with chronic heart failure (CHF) using CPET parameters. The predictive performance of these models was systematically compared, and model interpretability was evaluated using Shapley Additive exPlanations (SHAP). Subsequently, retaining only those with HF with preserved ejection fraction (HFpEF) for a sensitivity analysis. Additionally, a subgroup analysis was conducted between No-event group and Worsening HF (WHF) group.Results We used Boruta feature selection, four important predictive features were identified. Among the ML models constructed with these features, the Categorical Boosting (CatBoost) model demonstrated the best performance. SHAP analysis was applied to interpret the optimal model, revealing that lower values of heart rate recovery at 1 min (HRR1), as well as a higher carbon dioxide ventilation equivalent slope (VE/VCO2 slope), were associated with higher SHAP values—indicating greater importance in predicting adverse outcomes.Conclusion HRR1 and VE/VCO2 slope can serve as independent predictors for the incidence of MACCE in patients with CHF.

Alcohol dependence currently lacks targeted pharmacotherapies, underscoring the urgent need for novel therapeutic targets. Existing research on disease-associated DNA methylation changes and their gene regulatory effects remains inconsistent. To resolve this uncertainty, we applied the Mendelian randomization to elucidate causal mechanisms connecting druggable genes, epigenetic regulation and alcohol dependence development. Integrating MR, colocalization and mediation analyses, we leveraged genome-wide association study (GWAS) (FinnGen), eQTL (eQTLGen) and methylation (GoDMC) data. We assessed causal gene-alcohol dependence relationships, shared causal variants via colocalization and methylation-mediated regulatory mechanisms. Our integrative analysis identified 10 drug-targetable genes showing significant expression alterations in alcohol dependence (FDR < 0.05), with three genes (CDK5R1, CAMKK2 and NRBP1) demonstrating evidence of shared causal variants through colocalization. Epigenetic regulation was particularly evident at two methylation sites (cg07437263 and cg05102552) that indirectly influenced alcohol dependence risk by modulating CDK5R1 (63.92% mediation) and NRBP1 (95.12% mediation) expression. These findings reveal DNA methylation as a critical regulatory mechanism governing neuronal gene expression patterns in alcohol dependence pathogenesis. The strong mediation effects observed for CDK5R1 and NRBP1, coupled with their colocalization evidence, position these genes as promising candidates for both biomarker development and targeted therapeutic interventions in alcohol dependence. This investigation spotlights the regulatory function of DNA methylation on CDK5R1 and NRBP1 in alcohol dependence. It implies that CDK5R1 and NRBP1 could serve as potential clinical biomarkers or therapeutic targets for the early management of alcohol dependence.

OBJECTIVE:This study evaluated the effectiveness of acupuncture for improving pregnancy outcomes, endometrial receptivity (ER), and embryo transfer success in patients with recurrent implantation failure (RIF). METHODS:A retrospective cohort study was conducted using the medical records of 609 RIF patients undergoing frozen embryo transfer between January 2019 and June 2022. Patients were divided into two groups: those receiving acupuncture combined with hormone replacement therapy (HRT) or delayed HRT (d-HRT) and those receiving only HRT/d-HRT. Propensity score matching (PSM) ensured comparability between the groups. Clinical outcomes, including live birth rate (LBR), clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR) and biochemical pregnancy rate (BPR), were analyzed. Endometrial thickness, hormonal levels and uterine blood flow were also assessed. RESULTS:After PSM, 166 patients were included in each group. The acupuncture group demonstrated significantly higher CPR (36.5%), LBR (28.0%), OPR and BPR compared to the control group (P < 0.05). Endometrial thickness, and estradiol and progesterone levels were also significantly higher, while uterine resistance and pulsatility indices were lower in the acupuncture group (P < 0.05). Predictors of live birth included patient age (< 35 years, hazard ratio [HR] = 0.933, P = 0.002), body mass index (BMI) (< 24 kg/m2, HR = 0.974, P = 0.046), anti-Müllerian hormone (AMH) level (> 2 ng/mL, HR = 1.021, P = 0.043), high-quality embryo transfers (HR = 1.670, P < 0.05), and transferring two embryos (HR = 1.181, P < 0.05). CONCLUSION:Acupuncture significantly enhanced ER and improved LBR in RIF patients. Younger patients with lower BMI, higher AMH level, and high-quality or dual embryo transfers benefited most from this complementary therapy. Please cite this article as: Li HZ, Wu YJ, Li XR, Deng B, Pang YX, Lin SY, Lu LM, Li YM. Enhancing pregnancy outcomes in recurrent implantation failure: The role of acupuncture in improving endometrial receptivity. J Integr Med. 2026; 24(3):394-402.

Acupuncture research increasingly involves heterogeneous and multimodal data that are difficult to analyze using conventional methods. This review summarizes data-driven approaches in acupuncture research within a framework encompassing intervention, response, and contextual data. We discuss causal inference, artificial intelligence, text mining, and integrative analysis, along with their applications in efficacy evaluation, outcome prediction, mechanistic investigation, and clinical decision support. These approaches shift the focus of acupuncture research from population-level average effects toward individualized clinical decision-making by enabling the analysis of treatment heterogeneity and underlying mechanisms. However, current research remains limited by inadequate data standardization, insufficient external validation, and limited model interpretability. Despite these challenges, data-driven approaches offer substantial promise for advancing more rigorous and personalized acupuncture research.

Objective To investigate the clinical therapeutic effect on dysphagia following traumatic brain injury(TBI)treated with acupuncture using fiberoptic endoscopic evaluation of swallowing(FEES).Methods A total of 68 patients with dysphagia following TBI were enrolled and randomly divided into a control group and an acupuncture group,with 34 patients in each group.In the control group,the routine medical treatment and swallowing rehabilitation training were given.On the basis of the treatment as the control group,the patients in the acupuncture group received acupuncture at Lianquan(CV23),Jia-lianquan(Extra),bilateral Renying(ST23)and Fengchi(GB20),and Fengfu(GV16),with needles retained for 30 min in each treatment.The treatment was delivered once daily,with 6 treatments a week,and for a total of 3 weeks in the two groups.The scores of the standard swallowing assessment(SSA)and Kubota's water swallow test were compared between the two groups before and after treatment.FEES was used to observe the pharyngeal sensory function,pharyngeal motor function,accumulation of secretions,leakage-aspiration and food residue of the two groups.Results The scores of SSA and Kubota's water swallow test in both groups were reduced in comparison with those before treatment,and the decrease range in the acupuncture group was greater than that in control group(P<0.05).Pharyngeal sensory function,pharyngeal motor function,the score for accumulation of secretion,leakage-aspiration score and food residue degree were all improved in both groups compared with those before treatment,and the improvements in the acupuncture group were superior to the control group(P<0.05).The total effective rate in the acupuncture group was 94.12%(32/34),which was better than that of the control group(79.41%,27/34,P<0.05).Conclusion On the basis of routine medical treatment of internal medicine and rehabilitation training,acupuncture therapy significantly improves swallowing function in patients with dysphagia following TBI,particularly in enhancing pharyngeal motor function and sensory function.Besides,acupuncture effectively reduces the accumulation of pharyngeal secretions,and the severity of food leakage,aspiration,and residue during swallowing.

Objective: To analyze the research status and hotspots, and evolutionary trend of publications on Jin’s three-needle therapy from 2000 to 2025, and to provide bibliometric evidence for the theoretical development and clinical expansion of this distinctive Lingnan (the area south of the Nanling Mountains in China) acupuncture-moxibustion therapy. Methods: Relevant publications on Jin’s three-needle therapy were retrieved from China National Knowledge Infrastructure, VIP Database, Wanfang Data Knowledge Service Platform, and Chinese Biomedical Literature Database from January 1, 2000 to July 9, 2025. Two researchers independently screened and extracted data. Microsoft Excel was used for data management and disease spectrum analysis based on ICD-11 classification. CiteSpace software was employed to analyze publication trend, collaboration network, co-occurrence network, and keyword evolution. Results: A total of 1295 publications were included, showing an overall upward trend in annual output. Research mainly focused on diseases of the nervous system (45.17%), those of the musculoskeletal system or connective tissue (28.88%), and mental, behavioral or neurodevelopmental disorders (9.11%), accounting for over 80% in total. The study types were predominantly clinical research, the proportion of mechanistic research was relatively low, and mechanistic research was weak across all core fields. Collaboration network analysis revealed low density between authors and institutions, exhibiting a “core-edge” structure with Professor Rui JIN’ s inheritance team (Guangzhou University of Chinese Medicine and its affiliated hospitals) as the core and widespread in periphery, demonstrating a distinct geographical clustering characteristic in the Lingnan region. Keyword evolution indicated that the research focus had expanded from neurological rehabilitation to multisystem diseases, and the attention had been drawn in multidimensional outcomes such as quality of life and motor function. Conclusion: The research scale of Jin’s three-needle therapy has significantly expanded, demonstrating a relatively concentrated application distribution across three major domains: neurological disorders, musculoskeletal or connective tissue diseases, and mental, behavioral, or neurodevelopmental disorders. However, there are some shortcomings in the research of diseases, such as insufficient exploration of mechanisms and limited cooperation between teams and institutions. Future efforts should focus on strengthening mechanism research, conducting multicenter trials, and expanding inter-institutional collaboration to establish a more comprehensive evidence-based foundation, thereby enhancing the clinical reproducibility and academic influence of Jin’s three-needle therapy.

Existing reporting checklists lack the specificity and comprehensiveness required to effectively guide the documentation of acupuncture case reports. Therefore, we developed a reporting guideline tailored specifically for acupuncture case reports, building upon the CAse REport (CARE) statement. A multidisciplinary group of international experts including clinicians, researchers and methodologists was convened to draft the initial checklist in accordance with the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network. Through an extensive literature review and a series of expert interviews, the final CARE for acupuncture checklist comprised of 30 items. 38 experts from diverse disciplines participated in three rounds of modified Delphi surveys to refine and clarify these items. CARE for acupuncture is a comprehensive reporting guideline focused on acupuncture case reports developed with rigorous methodology. We hope that CARE for acupuncture will further guide authors, editors, peer reviewers and readers to enhance the transparency, completeness and accuracy of reporting of case reports in acupuncture.

This study used Mendelian randomisation (MR) to explore the putative causal relationship between obesity, leptin, brain alternations represented by magnetic resonance imaging (MRI) phenotypes, and Mediation MR to confirm the mediating role of leptin in obesity and brain changes. The fusiform surface area (SA) (pFDR = 0.005), the bankssts SA (pFDR = 0.022), and the second principal components for fractional anisotropy (FA PC) in posterior thalamic radiation (pFDR = 0.042) had negative causal effects on obesity. Obesity risk had negative causal effects on the first FA PC in superior frontal-occipital fasciculus (pFDR = 0.020) and mean fractional anisotropy (FA) of superior frontal-occipital fasciculus (pFDR = 0.020). Leptin content was positively associated with the risk of obesity (pFDR = 0.020). The inferior parietal SA was negatively correlated with leptin content (p = 0.022). Leptin may serve as a potential mediator of obesity-induced shrinkage of the inferior parietal SA (95

Background Cannabis use disorder (CUD) imposes a significant global health burden, yet comparative evidence for the diverse range of non-pharmacological interventions (NPIs) remains fragmented. Existing reviews often combine diverse NPIs into broad categories, overlooking the specific contributions of neurobiological modalities. This study aims to establish a comprehensive comparative efficacy hierarchy for non-pharmacological CUD interventions by integrating psychosocial therapies and neurotherapy into a unified analytical framework. Methods We will conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials comparing NPIs against control group(including waitlist, no-intervention, or non-specific control) or another NPIs for individuals with CUD. Systematic searches will be performed across PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Primary benefit outcomes will include biochemically verified cannabis abstinenc and self-reported days of cannabis use over the past 30 days. Primary acceptability will be evaluated by treatment retention, defined using an intention-to-treat approach as the proportion of randomized participants completing at least one session during the final treatment week, alongside follow-up retention rates. Primary safety will be assessed by the overall incidence of intervention-related adverse and serious adverse events. Pairs of reviewers will independently perform study selection, data extraction, and risk of bias. A frequentist NMA will be conducted to synthesize evidence. We will employ the Grading of Recommendations Assessment, Development and Evaluations(GRADE) approach to assess the certainty of evidence and categorize interventions using a minimally contextualized framework based on predefined decision thresholds. Results Comprehensive search strategies have been validated across target databases. Formal study screening, data extraction, quantitative network meta-analyses, and GRADE evidence assessments are scheduled for completion by September 2026, followed by final manuscript preparation. Conclusion This NMA will establish a comprehensive comparative evidence hierarchy for non-pharmacological CUD interventions by bridging psychosocial and neurobiological modalities. By pairing network estimates with GRADE certainty assessments, our findings will offer a standardized, actionable foundation for tailored clinical care and future trial methodology. Trial registration PROSPERO CRD420251173215 .

Background: Acupuncture (AT) therapy is an effective treatment for primary insomnia. However, no comprehensive study has compared and evaluated the efficacy and safety of multiple AT therapies and hypnotics. Methods: We searched eight databases from inception to July 2024 for randomized controlled trials (RCTs) of AT treatment for primary insomnia, including PubMed, Web of Science, Embase, Cochrane Library, Wanfang database, China National Knowledge Infrastructure database, and VIP Chinese Science and Technique Journals database. After screening, the Pittsburgh Sleep Quality Index (PSQI) score and clinical effectiveness rate were extracted from the included RCTs as outcome measures. We performed network meta-analysis using the Stata and R software. Results: Sixty-four RCTs involving 4443 patients were included in this study. Multiple AT therapies had better efficacy in improving PSQI scores than hypnotics, with AT combined with moxibustion (MOX) and AT combined with auriculotherapy (AU) as the best interventions. Regarding clinical effectiveness, acupoint catgut embedding (ACE) had the greatest potential of being the best intervention, and no serious adverse events related to AT therapies were observed in any of the studies. Conclusion: This review suggests that most AT therapies improve sleep indicators and have good clinical efficacy compared to hypnotics, especially AT combined with AU, AT combined with MOX, and ACE. The safety of AT therapies is reliable; however, the overall quality of the included trials was low, and higher-quality RCTs are required to provide sufficient evidence. Protocol registration: PROSPERO, CRD42017067402.

Objective:This study systematically assess the potential impact of various environmental pollutants as chemical, airborne, and heavy metal on ovarian function in women, focusing on ovarian reserve such as anti-Müllerian hormone (AMH) and antral follicle count (AFC) as well as hormone levels like follicle-stimulating hormone (FSH) and estradiol (E2). By reviewing epidemiological evidence, this research aims to elucidate the reproductive toxicity of these pollutants and provide scientific support for public health policy to protect reproductive health in women of childbearing age. Methods:Following the PRISMA-P guidelines, a comprehensive search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science databases to include all relevant studies up to July 30, 2024. The Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess study quality. Results:This study ultimately included 40 cohort study reports derived from 33 distinct studies that analyzed the effects of 20 pollutant types on ovarian function. Results indicate that pollutants, such as perfluoroalkyl and polyfluoroalkyl substances (PFAS), phthalates (PAEs), triclosan, Polychlorinated Biphenyls (PCBs), PM2.5, and SOX, have a significantly negative impact on ovarian function, especially among younger women (<35 years). Long-term exposure to particulate matter (PM)2.5 and PM10 is associated with a substantial decrease in ovarian reserve, while heavy metals (e.g., lead and cadmium) also demonstrate reproductive toxicity. However, these conclusions require validation due to both methodological limitations in the original studies (e.g., heterogeneous exposure assessments and residual confounding) and challenges in evidence synthesis (e.g., inconsistent outcome measures across cohorts), highlighting the need for further research to address these constraints. Conclusion:This review underscores that specific pollutants (e.g., PCBs, PFAS, PM) pose substantial risks to reproductive health in women of childbearing age, particularly in highly polluted environments. The findings underscore the importance of regular ovarian health monitoring, especially for women at higher risk due to occupational or environmental factors. Systematic review registration:PROSPERO CRD42024567744 (accessible at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024567744).

BACKGROUND:Diabetic peripheral neuropathy (DPN) has emerged as a global health challenge with increasing prevalence rates over the past 3 decades. Acupuncture has been increasingly utilized for the treatment of DPN in recent years. However, whether any specific acupuncture intervention should be considered a priority in the treatment of patients is still unclear.We aimed to summarize the latest evidence concerning the benefits and harms of acupuncture-related therapies to identify an optimal acupuncture intervention for DPN patients. METHODS:This systematic review and network meta-analysis searched databases from inception to October 2024 for randomized controlled trials (RCTs) evaluating acupuncture interventions in patients with DPN receiving mecobalamin therapy. We performed random-effects Bayesian network meta-analyses to synthesize evidence from eligible RCTs. RESULTS:Our systematic search identified 1831 citations with 62 eligible RCTs involving 5942 participants. Electroacupuncture may be the most effective at improving motor nerve conduction velocity (mean difference [MD]: 10.65; 95% confidence interval [CI]: 4.6-16.7), followed by acupoint injection (AI) combined with traditional Chinese medicine (TCM), AI, herbal fumigation (HF), manual acupuncture (MA), MA combined with HF, and MA combined with moxibustion, with MDs of (10.37; 95% CI: 6.17-14.61), (4.67; 95% CI: 2.57-6.82), (4.72; 95% CI: 1.31-8.14), (3.36; 95% CI: 2.1-4.64), (5.93; 95% CI: 2.53-9.33), and (4.8; 95% CI: 1.69-7.94). AI may be the most effective at improving sensory nerve conduction velocity (MD: 3.94; 95% CI: 2.33-5.57), followed by acupoint injection combined with TCM, bloom needle, HF, MA, MA combined with HF, MA combined with moxibustion, and MA combined with TCM, with MDs of 8.69 (95% CI: 3.72-13.61), 5.6 (95% CI: 2.2-8.99), 4.58 (95% CI: 1.49-7.71), 3.72 (95% CI: 2.62-4.85), 25 (95% CI: 1.64-6.85), 3.58 (95% CI: 1.13-6.08), and 5.7 (95% CI: 4.24-7.17), with low certainty evidence. CONCLUSION:Electroacupuncture may be the most effective therapy for improving motor nerve conduction function, and AI may be the best therapy for improving sensory nerve conduction function in patients with DPN.

BACKGROUNDS/AIMS:A number of studies have documented alterations in the structure and function of the striatum in individuals diagnosed with autism spectrum disorder (ASD). Nevertheless, the precise genetic mechanisms underpinning the relationship between autism spectrum disorder (ASD) and striatum and amygdala volume remain to be elucidated. The objective of this study was to estimate the causal effect of ASD on striatum and amygdala volume. METHODS:Summarized data of genome-wide association studies (GWAS) were separately downloaded from the IEU (Integrative Epidemiology Unit) open GWAS project (22138 participants of Europeans (100%), 18,382 cases of ASD and 27,969 controls, with a total of 33,219 brain imaged samples), the Enhancing Neuroimaging Genetics through Meta-Analysis Consortium (ENIGMA) (15640 participants of Europeans (96.5%) and non-Europeans). The MR-egger intercept test, MR-presso and Cochran's Q statistic was used to examine the pleiotropy and heterogeneity, respectively. MR-egger, weighted median, inverse variance weighted, simple mode, and weighted mode methods were used to evaluate the causal association between striatum and amygdala volume and ASD. Finally, the effect of a single SNP (single nucleotide polymorphism) was used to test the SNP bias. RESULTS:The increased change rate of the putamen shows a strong and statistically significant association with ASD risk (PIVW = 0.015, PFDR = 0.044), with a large beta value (β(SE) = 8.272(3.401), 95 %CI: 1.605 to 14.939) indicating a substantial effect size. This makes it a potentially important changes caused by ASD. However, the increased change rate of the amygdala shows a positive but not statistically significant association with ASD risk (PIVW = 0.119, PFDR = 0.593). The beta value (2.527) is smaller, and the confidence interval includes zero, suggesting that this result is not reliable as a predictor of ASD risk. The other part of GM (grey matter) of striatum and amygdala volume also showed unsignificant result due to small beta values or unsignificant FDR p values. CONCLUSIONS:The putamen's change rate appears to be a significant change caused by ASD which may be a strong predictive capability for ASD risk, while the amygdala's change rate and GM of striatum and amygdala volume does not show a significant predictive capability in this context. The present study provides evidence of a genetic relationship between ASD and putamen volume. Further investigation is required to elucidate the mechanisms underlying the genetic effect of changes in putamen structure and function on ASD.

Objective:. Long-term methadone maintenance treatment (MMT) requires gradual dose reduction to mitigate adverse effects; prior research has shown that acupuncture facilitates dose tapering and alleviates opioid cravings. Although medication dosage parameters hold significant clinical value in addiction medicine, the impact of early outpatient dose data on therapeutic effects currently remains unclear. This study aimed to construct a methadone dose reduction prediction model and analyze the clinical value of historical dose trajectories. Methods:. Data from two randomized trials (N = 197 patients across six Chinese MMT clinics) were analyzed, with participants grouped into the acupuncture and non-acupuncture cohorts. The primary outcome was combined outcome comprising methadone dose reduction and craving score changes. Pre-intervention dose trajectories were derived via cluster analysis and merged with baseline features. Five machine learning models were trained using SHapley Additive exPlanations (SHAP) to explain the feature contributions. Subgroup analyses linking trajectories to the effects of acupuncture were conducted. Results:. Methadone dose data were clustered into three trajectories. Model training included nine features from 11 variables. The CatBoost model achieved the best performance on the test set (area under the curve = 0.7531, accuracy = 0.8205). The SHAP summary plot revealed that the three most influential factors in methadone dose reduction were intervention type, body mass index, and dosage trajectory. Subgroup analysis showed that trajectory class 2 exhibited significantly better efficacy than class 0 at weeks 2 and 4 of acupuncture (week 2: risk difference, 20.4%, P = 0.015; week 4: risk difference, 27.5%, P = 0.013). Conclusions:. In this study, we established a trajectory-based prediction model for MMT dose reduction and demonstrated the clinical value of historical trajectories. The results suggest that acupuncture optimally supports patients with dynamic “rise-then-decline” trajectories, advancing personalized MMT strategies.

ABSTRACT:Antithrombotic therapy can prevent recurrent deep vein thrombosis (DVT) and pulmonary embolism (PE). It is, however, associated with an increased risk for major bleeding. This meta-analysis systematically reviewed the evidence regarding the duration of antithrombotic therapy to assess benefits and harms. We systematically searched for randomized controlled trials (RCTs) that compared shorter (3-6 months) with longer (>6 months) courses of anticoagulation for the primary treatment of venous thromboembolism (VTE) or that compared discontinued with indefinite antithrombotic therapy for the secondary prevention of VTE. Pairs of reviewers screened the eligible trials and collected data. This study included 22 RCTs (11 617 participants). Pooled estimates showed that, for the primary treatment of unprovoked VTE, VTE provoked by chronic risk factors or transient risk factors, treating patients with a longer course (>6 months) of anticoagulation, as opposed to a shorter course (3-6 months), probably reduced recurrent PE (risk ratio [RR], 0.66; 95% confidence interval [CI], 0.42-1.02) and DVT (RR, 0.85; 95% CI, 0.63-1.14), but it was associated with increased mortality (RR, 1.43; 95% CI, 0.85-2.41) (moderate certainty) and a higher risk for major bleeding (RR, 2.02; 95% CI, 1.02-3.98; high certainty). For the secondary prevention of unprovoked VTE and VTE provoked by chronic risk factors, when compared with discontinuing treatment, indefinite anticoagulation therapy was associated with decreased mortality (RR, 0.54; 95% CI, 0.36-0.81), a reduction in recurrent PE (RR, 0.25; 95% CI, 0.16-0.41) and DVT (RR, 0.15; 95% CI, 0.10-0.21), and an increase in the risk for bleeding (RR, 1.98; 95% CI, 1.18-3.30), all supported by high certainty. Indefinite antiplatelet therapy may be associated with decreased mortality (RR, 0.95; 95% CI: 0.53-1.68; low certainty), probably a reduction in recurrent PE (RR, 0.65; 95% CI, 0.41-1.03) and DVT (RR, 0.44; 95% CI, 0.17-1.13) (moderate certainty), and may increase the risk for bleeding (RR, 1.28; 95% CI, 0.48-3.41; low certainty). In summary, for the primary treatment of all types of VTE, shorter (3-6 months) duration of anticoagulation is more beneficial. For the secondary prevention of unprovoked VTE or VTE provoked by chronic risk factors, indefinite antithrombotic treatment is more beneficial.

Poststroke dysphagia (PSD) is a common complication after stroke but there is limited information on its global prevalence and influencing factors, such as spatial, temporal, demographic characteristics, and stroke-related factors. Our study seeks to fill this knowledge gap by exploring the overall prevalence of PSD and its influencing factors. A search of English-language literature from database inception from 2005 until May 2022 was performed using PubMed, Embase, Web of Science, Cochrane Library, and Scopus. We used the Joanna Briggs Institute Critical Appraisal Instrument to estimate study quality and calculated the pooled prevalence of PSD with a 95

BACKGROUND:Qu-yu-jie-du (QYJD) decoction is an established traditional Chinese medicine (TCM) formulation. For over ten years, there has been empirical evidence in support of its benefits for colorectal cancer patients, yet RCT validation for it as a postoperative maintenance therapy is lacking. Despite achieving no evidence of disease (NED) status after curative-intent resection in metastatic colorectal cancer (mCRC), up to 60 % of patients relapse within five years, with no guideline-recommended maintenance therapy. PURPOSE:To determine whether QYJD decoction improves disease-free survival (DFS) and modulates inflammation/lactate metabolism in postoperative mCRC-NED patients. METHODS/DESIGN:In this single-center randomized trial, 140 stage IV mCRC patients achieving post-resection NED status were randomized at a ratio of 1:1 to either a QYJD group (200 mL/day for 2 years) or a control group (routine follow-up). Two patients per group withdrew consent prior to the intervention, resulting in an intention-to-treat (ITT) population of 136 patients (68 per group) for the final analysis. All received standard adjuvant chemotherapy. The primary outcome was DFS; secondary outcomes were OS, 1-/2-/3-year survival rates, adverse events, and inflammation/lactate metabolism markers. RESULTS:Compared to the control group, QYJD decoction significantly improved DFS throughout the observation period (HR = 0.515, p = 0.004). The 1-year DFS rate was 91.2 % (62/68) in the QYJD group versus 73.5 % (50/68) in the control group (p < 0.01); the 2-year DFS rate was 56.9 % (40/68) in the QYJD group versus 35.1 % (25/68) in the control group (p = 0.002); and the 3-year DFS rate was 47.4 % (32/68) in the QYJD group versus 32.4 % (22/68) in the control group (p = 0.03). Significant differences were observed across all time points (1-year, 2-year, and 3-year) for DFS. Regarding overall survival (OS), the 2-year OS rate was 95.4 % (65/68) in the QYJD group versus 85.1 % (58/68) in the control group (p = 0.01), and the 3-year OS rate was 68.7 % (47/68) in the QYJD group versus 57.7 % (39/68) in the control group (HR = 0.407, p = 0.019). QYJD also significantly reduced inflammatory markers and lactate dehydrogenase (LDH) (p < 0.05). The most common adverse events were grade 1 hematologic toxicity, anorexia, diarrhea, and nausea, which were generally mild and manageable. CONCLUSION:QYJD decoction significantly improves DFS and shows OS benefits in postoperative mCRC-NED patients. It also reduces systemic inflammation/LDH, and in terms of safety, only causes mild adverse events. TRIAL REGISTRATION:Chinese Clinical Trial Registry (ChiCTR2100053521, registered on November 24, 2021).