Dehydroepiandrosterone (DHEA)-induced rodent models are widely used in polyendocrine metabolic ovarian syndrome (PMOS; formerly polycystic ovary syndrome [PCOS]) research, yet their reproducibility is limited by substantial methodological variability. While rats are often reported to exhibit diestrus arrest, mouse studies describe estrus-dominant or mixed-stage arrest, differences frequently attributed to species effects; however, heterogeneity in experimental design may also contribute. We synthesized 25 published DHEA-induced rodent studies and characterized estrous-cycle dynamics in a C57BL/6 model using one commonly used DHEA protocol. Key methodological variables-including induction age, DHEA brand and solvent, dosage, administration duration, smear-sampling timing, and cytological criteria-were extracted and examined using a semi-quantitative comparative approach. Estrous-arrest patterns were compared across methodological subgroups to formulate provisional, evidence-informed recommendations. Substantial variability in estrous-arrest patterns was identified across studies, although subgroup differences were not statistically significant. Approximately 60% of C57BL/6 studies reported estrus-dominant arrest when DHEA was administered at 6 mg/100 g body weight, sesame oil was used as the solvent, and induction began before postnatal day 28. Our experiment confirmed that the selected protocol can produce estrus-dominant arrest, but it did not compare alternative doses, solvents, induction ages, or sampling schedules. Directional trends suggested that DHEA dosage, solvent type, and induction age may contribute to estrous outcomes. Overall, methodological factors may contribute substantially to estrous-cycle variability in DHEA-induced mouse models; however, the available evidence does not establish them as dominant or causal determinants. These findings identify candidate methodological contributors and support provisional recommendations to improve reporting and cross-study comparability, while direct comparative experiments integrating endocrine and ovarian endpoints remain necessary for validation.

Introduction: Diminished ovarian reserve (DOR) refers to a decrease in the quantity and/or quality of oocytes in the ovaries, resulting in decreased fertility. DOR is one of the primary causes of infertility in women. Electroacupuncture therapy has been widely used in gynecological diseases. To our knowledge, there are currently no published case reports of electroacupuncture for two intermittent treatments of DOR-associated infertility. We present a case of electroacupuncture in two separate treatment sessions for DOR-associated infertility, resulting in a successful live birth following an initial miscarriage. Rationale: Infertility affects reproductive-aged couples and significantly impacts demographics trends. Electroacupuncture may be effective for DOR-associated infertility. Patient concerns: A 30-year-old woman presented with DOR-associated infertility and expressed concern about the substantial costs associated with assisted reproductive technology. Diagnoses: The patient was diagnosed with DOR-associated infertility and early threatened abortion. According to traditional Chinese medicine theory, the diagnosis was infertility (a deficiency in both the spleen qi and kidney qi, accompanied by blood stasis). Interventions: Based on the patient’s condition, we employed electroacupuncture to tonify qi and blood, and to invigorate blood circulation. Outcomes: After the first treatment, anti-müllerian hormone levels and antral follicle count increased, whereas baseline follicle-stimulating hormone levels decreased. The patient conceived but experienced a miscarriage due to embryonic chromosomal abnormalities despite normal parental karyotypes. Following the second treatment, the patient achieved a spontaneous pregnancy and delivered a healthy baby. Lessons: Electroacupuncture may improve pregnancy outcomes in DOR-associated infertility, and prolonging the treatment course could be beneficial for achieving a live birth.

Objective To observe the effect of electroacupuncture(EA)on histone deacetylase 3(HDAC3),synaptic plasticity and N-methyl-D-aspartate(NMDA)receptors in the hippocampus of mice with Alzheimer's disease(AD),so as to explore the underlying mechanism of EA in treatment of AD.Methods 5XFAD mice were randomly divided into EA group,model group and sham-acupuncture group,with 13 mice in both the EA group and the model group,and 7 mice in the sham-acupuncture group.Thirteen wild-type mice from the same litter were taken as the normal control group.The mice in the EA group received EA at"Baihui"(GV20)and"Dazhui"(GV14)for 15 min once daily,6 times a week for 4 weeks.The mice in the sham-acupuncture group received sham EA,i.e.,the needle was inserted into the rubber clay which was placed on the surface of the corresponding acupoints.The novel object recognition(NOR),Y-maze and Morris water maze(MWM)tests were used to observe the cognitive functions of mice.Electrophysiological technique was used to detect long-term potentiation(LTP)of the hippocampal neurons and Western blot was used to detect the relative expressions of HDAC3 and NMDAR-related receptors(NMDAR1,NMDAR2A,NMDAR2B)in the hippocampus.Results Compared with the normal control group,5XFAD mice in the model group showed decreased(P<0.01,P<0.05)preference index for new object recognition,alternative arm ratio(AAR),number of times crossing the original platform,percentage of time and distance traveled in the target quadrant,NMDAR2B,NMDAR2A and NMDAR1 protein expression levels,with prolonged(P<0.01)escape latency,and increased(P<0.05)protein relative expression of HDAC3.At the same time,with high-frequency stimulation,the slope of fEPSP was decreased(P<0.01,P<0.05)in the 5XFAD mice.After EA intervention,comparison between the EA and the model groups revealed that,the preference index for new object recognition,AAR were increased(P<0.01,P<0.05)in the EA group,the escape latency was shortened(P<0.05),and the number of times crossing the platform,percentage of time and distance traveled in the target quadrant,the slope of fEPSP,and the protein relative expressions of NMDAR2B,NMDAR2A and NMDAR1 in the hippocampus were increased(P<0.01,P<0.05),while the protein relative expression of HDAC3 decreased(P<0.01).Compared with sham-acupuncture group,the above indexes improved to different degree in the EA group(P<0.01,P<0.05).Conclusion EA of GV20 and GV14 can restore the impaired LTP and improve the cognitive impairment,which may be related to increasing the expressions of NMDA-related receptor proteins and down-regulating the expression of HDAC3 in the hippocampus of 5XFAD mice.

Background:Aortic dissection (AD) is a life-threatening cardiovascular emergency characterized by rapid onset and high mortality. While surgery intervention, the primary treatment, improves short-term survival, it frequently leads to postoperative complications including systemic inflammatory response syndrome, gastrointestinal dysfunction, and anxiety/depression. These complications may be exacerbated by dysregulation of the gut-brain axis (GBA). Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique known to exert anti-inflammatory, prokinetic, and neuroregulatory effects in various conditions; however, its application for managing postoperative complications in AD remains unexplored. This study aims to evaluate the efficacy and safety of taVNS in regulating the GBA among postoperative AD patients through a randomized controlled trial. Methods:This is a single-center, randomized, investigator-blinded, sham-controlled randomized controlled trial. A total of 50 patients aged 18-75 years with postoperative Stanford Type A or B AD will be enrolled and randomly assigned in a 1:1 ratio to either the active taVNS group or the sham control group. Both groups will receive standard postoperative care. The experimental group will additionally receive active taVNS targeting the vagus nerve-innervated auricular area (15 Hz, 200 μs pulse width), while the control group will receive sham stimulation at a non-vagus innervated site without electrical current. The intervention will be administered for 30 min, twice daily, over 7 consecutive days, with follow-up assessments continuing until 24 weeks post-surgery. Primary outcomes include changes in gut microbiota diversity/abundance and brain function (assessed via functional near-infrared spectroscopy). Secondary outcomes encompass inflammatory markers, plasma neurotransmitter levels, intestinal function recovery, and relevant psychometric scale scores. Safety will be monitored through vital signs, laboratory tests, and recording of any adverse events. Discussion:This study is the first to innovatively integrate taVNS with the GBA theory, investigating its multi-target mechanisms through a comprehensive set of biomarkers and clinical endpoints. If proven effective, taVNS could offer a safe and cost-effective non-pharmacological adjunctive therapy for managing postoperative complications in AD. Furthermore, the findings have the potential to elucidate the role of the GBA in the recovery trajectory of patients following major cardiovascular surgery. Trial Registration:Chinese Clinical Trial Registry (ChiCTR, http://www.chictr.org.cn), No. ChiCTR2500102345, Date: May 13, 2025.

ABSTRACT Introduction Preliminary studies have indicated that acupuncture may play a role in the management of negative emotions in patients with PCOS. However, the available evidence is predominantly of low quality. Consequently, a meta‐analysis was conducted to assess the validity of acupuncture as a therapeutic modality for treating negative emotional symptoms in patients with PCOS. Methods A meticulous search of nine databases was performed to identify randomized controlled trials assessing the effectiveness of acupuncture in the management of negative emotions in individuals diagnosed with PCOS. The principal outcome was evaluated using the SDS and SAS scales, while secondary outcomes encompassed the Rosenfield scores, Ferriman–Gallwey (F–G) scores, and BMI. The risk of bias was appraised with the Cochrane RoB 2.0 tool. The certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Results This meta‐analysis synthesized the findings of seven studies that collectively provided evidence supporting the hypothesis that acupuncture may be more effective than drug treatment in alleviating SDS. However, the findings did not demonstrate significant efficacy in improving SAS. The analysis further revealed that acupuncture could effectively improve the F–G score in patients with PCOS, although it was not significantly effective for the Rosenfield score. The GRADE assessment assigned a low level of certainty to the SDS and F–G scores and a very low level of certainty to the SAS, Rosenfield, and BMI scores, emphasizing the necessity for additional high‐quality RCTs to validate these findings. Conclusion This study identified the potential of acupuncture in alleviating depression in patients with PCOS. Nonetheless, the evidence substantiating these findings was restricted by the poor quality of the included RCTs, precluding the drawing of definitive conclusions. Until more substantial evidence emerges, caution should be exercised regarding assertions of the therapeutic potential of acupuncture for treating negative emotions associated with PCOS.

Background purpose:The adjunctive effect of acupuncture for cerebral infarction (CI) remains inconsistent. We aimed to determine its anti-inflammatory effect, assess safety, and summarize the adjunctive use of acupuncture for CI. Methods:We identified qualified randomized controlled trials (RCTs) from eight literature databases. Frequency analysis and Apriori association analysis were conducted using SPSS Modeler 18.0 and SPSS 26.0 software. A meta-analysis was performed using Stata 17.0 software. The credibility of the meta-results and the certainty of the evidence was assessed using trial sequential analysis (TSA) and GRADE methods, respectively. Results:A total of 43 RCTs were included, comprising 3,861 participants. Acupuncture with intermittent treatment (5-7 times per week), a combination of multiple points and multiple meridians (an average of 9.35 points in each prescription), typically lasting for 2-4 weeks, was commonly used for CI treatment. Meta-analysis indicated that the adjunctive use of acupuncture reduced levels of TNF-α (SMD = -1.36; 95% CI -1.51 to -1.20, p < 0.01), hs-CRP (SMD = -0.86; 95% CI -0.99 to -0.74, p < 0.01), and IL-6 (SMD = -0.85; 95% CI -1.08 to -0.62, p < 0.01), and decreased the rate of adverse events (RR = 0.71; 95% CI 0.49 to 1.01; p < 0.05). The certainty of the evidence was rated as moderate to high. Conclusion:Intermittent acupuncture treatment lasting at least 2 w was commonly used for CI patients, typically involving multiple acupuncture points and meridians. Acupuncture demonstrated an anti-inflammatory effect in the treatment of CI. However, due to the low quality of the existing literature, high-quality randomized controlled trials (RCTs) are required to confirm these results in the future. Systematic review registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42017078583.

Chronic prostatitis (CNP) is a prevalent inflammatory disorder among men. The Xialiqi capsule has been reported to alleviate the clinical symptoms of CNP patients, which may be related to its anti-inflammatory effect; yet, its exact mechanism of action remains unclear. In this study, human normal prostate epithelial cells (RWPE-2 cells) were categorized into a control group, a model group, an inhibitor group, along with high, medium, and low drug-containing serum groups (5%, 10%, and 15%, respectively). With the exception of the control group, cell pyroptosis models were created by stimulating with lipopolysaccharide (100 ng/mL) and adenosine triphosphate (5 mM). Subsequently, drug-containing serum and the NOD-like receptor 3 ( NLRP3 ) inhibitor (MCC950) were utilized to intervene with the model cells according to their respective groups. Post-administration of MCC950 and drug-containing serum, an improvement in cell viability was noted in the inhibitor group and medium-high dosage groups (by 20.5%, 38.2%, and 73.2%). Transmission electron microscopy indicated a reduction in the features characteristic of cell pyroptosis. Levels of nitric oxide, interleukin-18 (IL-18), and tumor necrosis factor-α in the cellular supernatant decreased significantly (60.7%, 21.6%, 33.7%, 41.8%; 49.2%, 54.8%, 53.5%, 69.3%; 31.3%, 44.4%, 38.1%, 51.2%). Immunofluorescence showed reduced fluorescence intensity of NLRP3 and Cysteine aspartate protease-1 (Caspase-1) proteins, and Western Blot analysis revealed a significant decline in the expression of NLRP3, pro-Caspase-1, and gasdermin D (20.5%, 45.9%, 58.1%, 74.8%; 23.2%, 36.7%, 51.6%, 51.9%; 15.4%, 28.6%, 33.1%, 39.2%). In vitro experiments suggest that the Xialiqi capsule may treat CNP by regulating prostate epithelial cell pyroptosis and reducing inflammatory factor release via inhibiting the NLRP3/Caspase-1 signaling pathway. This study offers a novel approach for future CNP treatment with traditional Chinese medicine preparations, deserving further promotion.

The dehydroepiandrosterone (DHEA)-induced mouse model is widely used to study polycystic ovary syndrome (PCOS), yet findings on antral follicle (AF) dynamics remain inconsistent. Among 12 representative studies—classified as mechanistic (n = 1), intervention (n = 7), or mixed-type (n = 4)—half reported increased AF counts, while the others reported reductions. This variability likely stems from methodological differences, including DHEA dosage, solvent, animal age, treatment duration, follicle classification, and estrous cycle control. AMH, a key regulator of folliculogenesis, was reported in only one study, limiting mechanistic interpretation. Our subgroup and forest plot analyses suggest that ethanol solvents, younger animals, and longer treatment durations may increase the likelihood of AF elevation, though none reached statistical significance and these results should be interpreted as exploratory due to small sample sizes and study heterogeneity. We propose standardizing key variables such as AMH measurement, follicle classification, histological sectioning, estrous cycle staging, and DHEA administration protocols. Although the DHEA model recapitulates reproductive hallmarks of PCOS—such as hyperandrogenism and follicular arrest—it incompletely reflects the metabolic and neuroendocrine features of human PCOS, limiting its translational fidelity. These findings highlight the need for greater methodological transparency and standardization to improve the translational value of preclinical PCOS models.

As one of the commonly used therapies for pain-related diseases in clinical practice, electroacupuncture (EA) has been proven to be effective. In chronic pain, neurons in the anterior cingulate cortex (ACC) have been reported to be hyperactive, while the mechanism by which cannabinoid type 1 receptors (CB1Rs) in the ACC are involved in EA-mediated analgesic mechanisms remains to be elucidated. In this study, we investigated the potential central mechanism of EA analgesia. A combination of techniques was used to detect the expression and function of CB1R, including quantitative real-time PCR (q-PCR), western blot (WB), immunofluorescence (IF), enzyme-linked immunosorbent assay (ELISA), and in vivo multichannel optical fibre recording, and neuronal activity was examined by in vivo two-photon imaging and in vivo electrophysiological recording. We found that the hyperactivity of pyramidal neurons in the ACC during chronic inflammatory pain is associated with impairment of the endocannabinoid system. EA at the Zusanli acupoint (ST36) can reduce the hyperactivity of pyramidal neurons and exert analgesic effects by increasing the endocannabinoid ligands anandamide (AEA), 2-arachidonoylglycerol (2-AG) and CB1R. More importantly, CB1R in the ACC is one of the necessary conditions for the EA-mediated analgesia effect, which may be related to the negative regulation of the N-methyl-D-aspartate receptor (NMDAR) by the activation of CB1R downregulating NR1 subunits of NMDAR (NR1) via histidine triad nucleotide-binding protein 1 (HINT1). Our study suggested that the endocannabinoid system in the ACC plays an important role in acupuncture analgesia and provides evidence for a central mechanism of EA-mediated analgesia.

Objective: To investigate the effects of electroacupuncture (EA) at ST36 on intestinal microflora and plasma metabolites in a mouse model of type 2 diabetes mellitus (T2DM), to provide a theoretical basis and guidance for the clinical treatment of T2DM by traditional Chinese medicine (TCM). Methods: Sixteen T2DM db/db mice were randomly divided into treatment (T, n = 8) and model (M, n = 8) groups, and a further eight normal db/m+ mice reared under the same conditions served as a non-diabetic control group (C, n = 8). The general conditions of mice were observed weekly. After obtaining blood and stool samples, the mice were euthanized. Fasting blood glucose (FBG) was measured using a glucometer and fasting insulin (FINS) was measured in plasma by enzyme-linked immunosorbent assay (ELISA). Liver and colon tissues were embedded in paraffin and subjected to hematoxylin–eosin (HE) staining to observe pathological changes in these tissues. In addition, 16S ribosomal RNA (rRNA) sequencing was performed to analyze changes in the intestinal flora and metabolomics was employed to assess changes in metabolites in the blood. Results: EA significantly reduced FBG and FINS levels and alleviated pathological damage to the liver and colon. Furthermore, EA increased intestinal community richness and diversity by decreasing the relative abundance of Clostridium and incresasing the relative abundance of Lactobacillus. EA also reduced D-fructose levels in T2DM mice according to plasma metabolomics. Conclusion: EA has a positive regulatory effect on the intestinal flora and can regulate blood glucose and improve insulin resistance in T2DM model mice.

AIMS Electroacupuncture (EA) at the Lianquan (CV23) could alleviate swallowing dysfunction. However, current knowledge of its neural modulation focused on the brain, with little evidence from the periphery. Transient receptor potential channel vanilloid subfamily 1 (TRPV1) is an ion channel predominantly expressed in sensory neurons, and acupuncture can trigger calcium ion (Ca2+ ) wave propagation through active TRPV1 to deliver signals. The present study aimed to investigate whether TRPV1 mediated the signal of EA to the primary sensory cortex (S1) during regulation of swallowing function. METHODS Blood perfusion was evaluated by laser speckle contrast imaging (LSCI), and neuronal activity was evaluated by fiber calcium recording and c-Fos staining. The expression of TRPV1 was detected by RNA-seq analysis, immunofluorescence, and ELISA. In addition, the swallowing function was assessed by in vivo EMG recording and water consumption test. RESULTS EA treatment potentiated blood perfusion and neuronal activity in the S1, and this potentiation was absent after injecting lidocaine near CV23. TRPV1 near CV23 was upregulated by EA-CV23. The blood perfusion at CV23 was decreased in the TRPV1 hypofunction mice, while the blood perfusion and the neuronal activity of the S1 showed no obvious change. These findings were also present in post-stroke dysphagia (PSD) mice. CONCLUSION The TRPV1 at CV23 after EA treatment might play a key role in mediating local blood perfusion but was not involved in transferring EA signals to the central nervous system (CNS). These findings collectively suggested that TRPV1 may be one of the important regulators involved in the mechanism of EA treatment for improving swallowing function in PSD.

BACKGROUND:This study aimed to investigate the effects of combined spinal-epidural anesthesia (CSEA) with acupoint injection (AI) on the maternal-fetal expression of interleukin-1β (IL-1β), interleukin-10 (IL-10), analgesia effect, and labor outcomes.METHODS:A total of 360 healthy primiparas were randomized into the CSEA+AI group, the CSEA group, the AI group, and the control group (n = 90, each group) according to the labor analgesia methods.RESULTS:Compared to the CSEA group, the CSEA+AI group had significantly lower visual analog scale (VAS) scores, adverse events, dose of ropivacaine/sufentanil, and shorter labor durations. The IL-1β/IL-10 ratio in maternal peripheral blood and umbilical cord blood was reduced in the CSEA+AI group compared with the CSEA group.CONCLUSION:The combination of CSEA and AI can reduce the ratio of IL-1β/ IL-10 in maternal peripheral blood and umbilical cord blood, which can effectively relieve labor pain.

Polycystic ovarian syndrome (PCOS) is a common, complex, and heterogeneous endocrine and metabolic disorder. There is no standardized treatment, and it therefore requires individualized therapies according to the symptoms and pathogenesis of each patient. The present study aimed to determine the effect of electroacupuncture at the acupoints Zusanli (ST36), Sanyinjiao (SP6), and Neiguan (PC6) on reproductive disorders and insulin resistance in a murine model of PCOS induced by dehydroepiandrosterone (DHEA). Vaginal smear analysis was used to determine mice estrous cycle; intraperitoneal glucose and insulin tolerance tests were adopted to analyze metabolic characteristics; enzyme-linked immunosorbent assay was used to measure hormone levels; gene expression was quantified with real-time PCR; hematoxylin and eosin staining was used to observe ovarian morphology. We observed disordered estrous cycle, polycystic ovarian morphology, and higher levels of homeostasis model assessment-insulin resistance (HOMA-IR) and testosterone (T), indicating successful modeling of PCOS. DHEA increased levels of estrogen (E2), progesterone (P), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), and EA treatment restored them to levels seen in the control group. EA reduced the days in estrus caused by DHEA, improved the abnormal sex hormone receptor genes, and attenuated the DHEA-induced histomorphological changes in mouse ovaries. The average expressions of the androgen receptor (AR), estrogen receptor (ER), luteinizing hormone receptor (LHR), and follicle-stimulating hormone receptor (FSHR) genes in the ovary greatly increased after DHEA treatment and significantly decreased in the DHEA + EA group. After EA treatment, the cystic follicle (CF) number was reduced and corpora lutea (CL) increased in the DHEA + EA group compared to the DHEA group. EA improved glucose intolerance and insulin intolerance. Statistical analysis of intraperitoneal glucose tolerance test-area under curve (IPGTT-AUC) glucose levels revealed a significant decrease in DHEA group mice compared to the control and DHEA + EA groups. EA was found to restore fasting blood glucose, fasting serum insulin, and HOMA-IR. In summary, our study suggests that EA has a remarkable effect in the DHEA-induced murine PCOS model. Management of EA could improve estrous cycle, hormonal disorders, abnormal sex hormone receptors in ovaries, ovary morphology, and insulin resistance in PCOS mice.

BACKGROUND:Opposing needling has an obvious curative effect in the treatment of post-stroke hemiplegia; however, the mechanism of the opposing needling in the treatment of post-stroke hemiplegia is still not clear. The purpose of this study is to investigate the effect of opposing needling on the excitability of primary motor cortex (M1) of healthy participants and patients with post-stroke hemiplegia, which may provide insight into the mechanisms of opposing needling in treating post-stroke hemiplegia.METHODS:This will be a single-blind, randomised, sham-controlled trial in which 80 healthy participants and 40 patients with post-stroke hemiplegia will be recruited. Healthy participants will be randomised 1:1:1:1 to the 2-Hz, 50-Hz, 100-Hz, and sham electroacupuncture groups. Patients with post-stroke hemiplegia will be randomised 1:1 to the opposing needling or conventional treatment groups. The M1 will be located in all groups by using neuroimaging-based navigation. The stimulator coil of transcranial magnetic stimulation (TMS) will be moved over the left and right M1 in order to identify the TMS hotspot, followed by a recording of resting motor thresholds (RMTs) and motor-evoked potentials (MEPs) of the thenar muscles induced by TMS before and after the intervention. The primary outcome measure will be the percent change in the RMTs of the thenar muscles at baseline and after the intervention. The secondary outcome measures will be the amplitude (μV) and latency (ms) of the MEPs of the thenar muscles at baseline and after the intervention.DISCUSSION:The aim of this trial is to explore the effect of opposing needling on the excitability of M1 of healthy participants and patients with post-stroke hemiplegia.TRIAL REGISTRATION:Chinese Clinical Trial Registry ChiCTR1900028138 . Registered on 13 December 2019.

OBJECTIVE:To explore if acupoint injection can improve analgesic effects or delivery outcomes in parturients who received combined spinal-epidural analgesia (CSEA) and patient-controlled epidural analgesia (PCEA) for labor analgesia.METHODS:A total of 307 participants were prospectively collected from July 2017 to December 2019. The participants were randomized into the combined acupoint injection with CSEA plus PCEA group (AICP group, n=168) and CSEA plus PCEA group (CP group, n=139) for labor analgesia using a random number table. Both groups received CSEA plus PCEA at cervical dilation 3 cm during labor process, and parturients of the AICP group were implemented acupoint injection for which bilateral acupoint of Zusanli (ST 36) and Sanyinjiao (SP 6) were selected in addition. The primary outcome was Visual Analogue Scale (VAS) score, and the secondary outcomes were obstetric outcomes and requirement of anesthetics doses. Safety evaluations were performed after intervention.RESULTS:The VAS scores were significantly lower in the AICP group than in the CP group at 10, 30, 60, and 120 min after labor analgesia (all P<0.05). The latent phase of the AICP group was shorter than that of the CP group (P<0.05). There were less additional anesthetics consumption, lower incidences of uterine atony, fever, pruritus and urinary retention in the AICP group than those in the CP group (all P<0.05).CONCLUSION:Acupoint injection combined CSEA plus PCEA for labor analgesia can decrease the anesthetic consumption, improve analgesic quality, and reduce adverse reactions in the parturients. (Registration No. ChiMCTR-2000003120).

Background It is well known that lipids are vital for axonal myelin repair. Diffuse axonal injury (DAI) is characterized by widespread axonal injury. The association between serum lipids and DAI is not well known. The purpose of this study was to investigate the associations of serum lipid profile variables (triglycerides, high- and low-density lipoproteins, and total cholesterol) with DAI detected by magnetic resonance imaging (MRI) and with clinical outcome for patients suffering from traumatic brain injury (TBI). Methods This study included 176 patients with a history of TBI who had undergone initial serum lipid measurements within 1 week and brain MRIs within 30 days. Based on MRI findings, patients were divided into negative and positive DAI groups. Results Of the 176 patients, 70 (39.8%) were assigned to DAI group and 106 (60.2%) patients to non-DAI group. Compared with the non-DAI group, patients with DAI had significantly lower levels of high-density lipoprotein cholesterol (HDL-C) in serum during the first week following TBI. Multivariate analysis identified HDL-C as an independent predictor of DAI. Patients with lower serum HDL-C levels were less likely to regain consciousness within 6 months in TBI patients with DAI lesions identified by MRI. Conclusions Plasma levels of HDL-C may be a viable addition to biomarker panels for predicting the presence and prognosis of DAI on subsequent MRI following TBI.

BACKGROUND:Hemiplegia after stroke is one of the main dysfunctions in stroke patients. Acupuncture had been widely used for poststroke spastic hemiplegia (PSSH), but the efficiency was unclear. This study aimed to examine the efficiency and safety of acupuncture for individuals with PSSH. METHODS:We searched nine databases from their inception to 27th July 2019. Randomized controlled trials (RCTs) of acupuncture for the treatment of PSSH met the screening criteria. The quality of methodology was evaluated by Cochrane's risk of bias tool. RevMan 5.3 was used to perform the meta-analysis. The primary outcome was the Fugl-Myer Assessment (FMA) score, and the secondary outcomes were the Ashworth Scale for Spasticity (ASS) and Barthel Index (BI) scores. To evaluated the safety of acupuncture therapy, researchers scanned the full text to collect adverse events. RESULTS:Researchers retrieved 2452 articles in total, after screening, thirty-eight studies with 2628 participants of were included. In this meta-analysis, twenty-seven trials revealed that acupuncture therapy was associated with an increase in FMA scores compared with rehabilitation training (RT) (MD: 8.43, 95% CI, 6.57 to 10.28, p < 0.00001, I2 = 75%). According to the analysis of subgroup of interventions, ten trials showed that manual acupuncture (MA) plus RT was associated with an increase in FMA compared with RT (MD: 10.84, 95% CI, 9.29 to 13.29, p < 0.00001, I2 = 24%), three trials showed that electroacupuncture (EA) plus RT was associated with an improvement in FMA compared with RT (MD: 9.44, 95% CI, 1.00 to 17.88, p = 0.03, I2 = 81%), twelve trials showed that MA was associated with an increase in FMA compared with RT (MD: 5.48, 95% CI, 2.07 to 8.89, p = 0.002, I2 = 74%), and one trials showed that EA was associated with an improvement in FMA compared with RT (MD: 11.35, 95% CI, 5.03 to 17.67, p = 0.0004). According to the analysis of subgroup of treatment duration, four trials used acupuncture therapy for more than 1 month, revealed that acupuncture therapy was associated with an increase in FMA scores compared with RT (MD: 9.24, 95% CI, 0.42 to 18.06, p = 0.04, I2 = 93%). Thirty-two trials used acupuncture therapy for less than or equal to 1 month, revealed that acupuncture therapy was associated with an increase in FMA scores compared with RT (MD: 8.32, 95% CI, 6.56 to 10.09, p < 0.00001, I2 = 61%). Six trials indicated that acupuncture therapy was better than RT in terms of the ASS (MD: 0.46, 95% CI, -0.65 to -0.27, p < 0.00001, I2 = 67%), twenty-four trials indicated that acupuncture therapy was better than RT in terms of the BI scores (MD: 8.32, 95% CI, 5.30 to 11.35, p < 0.00001, I2 = 88%). In general, the methodologies of the RCTs were of poor quality. Two RCTs reported no adverse events, one trial reported five adverse events without severe influence, others did not mention. CONCLUSIONS:This review discovered that acupuncture might be a safe and effective adjuvant therapy for individuals with PSSH. Nevertheless, there were methodological limitations in the included RCTs, and well-designed and large-scale studies should be carried out to confirm our results.

OBJECTIVE To explore the protective effect of SBi4211 (heptamidine), an inhibitor of S100B, against central nervous system injury induced by HIV-1 envelope protein gp120. METHODS In an in vitro model, U251 glioma cells were co-cultured with SH-SY5Y cells to explore the protective effect of SBi4211 against gp120-induced central nervous system injury. In a gp120 transgenic (Tg) mouse model (8 months old) mimicking HIV-associated neurocognitive disorder (HAND), the effect of treatment with gp120 or both gp120 and SBi4211 on neuronal activity and apoptosis were assessed using Cell Counting kit-8 (CCK-8) and flow cytometry. ELISA, Western blotting and immunohistochemistry were used to determine the expression levels of S100B, RAGE, GFAP, NeuN, Syn, MAP-2 and the inflammatory factors IL-6 and TNF-α. RESULTS In the cell co-culture system, SBi4211 treatment significantly inhibited gp120-induced expression of S100B, RAGE and GFAP in U251 cells (P < 0.001), reduced the levels of inflammatory factors iNOS, IL-6 and TNF-α (P < 0.001) and enhanced the expressions of neuron-related proteins NeuN, Syn and MAP-2 (P < 0.001). In the transgenic mouse model, SBi4211 treatment significantly reduced the expressions of S100B, RAGE and inflammation levels (P < 0.05), inhibited the activation of astrocytes in the brain, and maintained the integrity of the neurons (P < 0.05). CONCLUSIONS SBi4211 can protect neurons from gp120-induced neurotoxicity possibly by inhibiting the S100B/ RAGE-mediated signaling pathway.