Postpartum depressive disorder (PPD) is a unique subtype of major depressive disorder and a substantial contributor to maternal morbidity and mortality. However, the pathogenesis of PPD has still remained elusive, and it may associate with genetic and environmental factors. Gut microbiota has already been proved to be associated with depression; however, a limited number of studies have concentrated on PPD. The present study aimed to explore the potential correlations between gut microbiota and PPD. In this study, 57 participants were enrolled, in which fecal samples of 28 patients with PPD and 16 healthy controls (HCs) were collected and then analyzed by high-throughput sequencing of the 16S ribosomal RNA (rRNA) gene. The results showed that diversity and composition of gut microbial communities were partly different between PPD patients and HCs. The relative abundance of Firmicutes phyla was lower in PPD patients. The levels of several predominant genera were significantly different between PPD patients and HCs. More importantly, the PPD patients experienced reduced levels of Faecalibacterium, Phascolarctobacterium, Butyricicoccus, and Lachnospiraceae, as well as increased levels of Enterobacteriaceae family. In addition, a correlation was observed between levels of Phascolarctobacterium, Lachnospiraceae, Faecalibacterium, and Tyzzerella.3 and the severity of depressive symptoms. Various kinds of bacteria, such as Lachnospiraceae and Faecalibacterium, were found to be associated with levels of sex hormones. This study indicated the correlation between gut microbiota and PPD, and gut microbiota-based biomarkers may be helpful for the diagnosis and treatment of PPD patients. However, further studies need to be conducted to clarify the cause–effect relationship between PPD patients and gut microbiota and to highlight the suitability of gut microbiome as a biomarker.

Objective. This study aimed at assessing the clinical effectiveness of acupuncture for lateral epicondylitis (LE). Methods. The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. Randomized controlled trials (RCTs) meeting the inclusion criteria were included. RevMan 5.3 software was used to conduct meta-analyses. The study quality was evaluated with the Cochrane risk of bias. Results. Ten RCTs involving 796 individuals were included in this meta-analysis. Three studies reported randomized methods with a specific description. For the analyses of the clinical efficacy rate, acupuncture outperformed sham acupuncture (two RCTs, n = 130, P=0.15), medicine therapy (two RCTs, n = 124, P=0.02), and blocking therapy (four RCTs, n = 427, P=0.0001). For the analyses of the visual analog scale, acupuncture outperformed sham acupuncture (two RCTs, n = 92, P=0.18), medicine therapy (two RCTs, n = 144, P<0.00001), and blocking therapy (two RCTs, n = 132, P=0.03). The subgroup analyses comparing acupuncture with sham acupuncture therapy revealed heterogeneities. The follow-up information and adverse reactions were not analyzed because of the insufficient number of studies. Conclusions. Acupuncture appears to be superior to drug or blocking therapy or sham acupuncture therapy for LE. However, considering the low quality of the available trials, further large-scale RCTs with a low risk of bias are needed in the future.

Background: Increasing evidences demonstrate that immune dysregulation can result in depression, and it is reported that persistent inflammatory response is related to the unresponsiveness of antidepressant treatment. Purpose: This study aimed to explore the reason why some responded but some not responded to acupuncture in treating postpartum depression (PPD), and whether it related to the levels of inflammatory cytokines. Patients and Methods: Women diagnosed with PPD were recruited in to accept 8-week acupuncture. All subjects were assessed the 17-item Hamilton Depression Rating Scale (HDRS17) at baseline, week 1, week 2, week 4 and week 8 during the treatment. A panel of 9 cytokines was measured at baseline and 8 weeks. Results: Of the 121 participants, 96 completed the 8-week assessment and 46 completed the blood sample collection. HDRS17 scores of 96 subjects showed significant statistical reduction since the first week (P = 0.002) and reached to 5.31 (P < 0.000) at the end of therapy. And we divided the 46 subjects into responders and non-responders according to the response rate of HDRS17 scores. Responders and non-responders did not differ significantly between-group in changes in the 9 cytokines. In responders, IL-6, IL-10 and IFN-γ levels were statistically lower (P = 0.006; P = 0.033; P = 0.024), while TGF-β 1 was statistically higher after 8 weeks treatment (P < 0.000). In non-responders, the levels of IL-5, TNF-α and TGF-β 1 were statistically higher (P = 0.018; P < 0.000; P < 0.000), while IFN-γ was statistically lower (P = 0.005). Conclusion: Acupuncture could alleviate depressive symptoms of patients with PPD and might through adjusting peripheral inflammatory response by up-regulating anti-inflammatory cytokines and down-regulating pro-inflammatory cytokines.

Background: There are several clinical and molecular predictors of responses to antidepressant therapy. However, these markers are either too subjective or complex for clinical use. The gut microbiota could provide an easily accessible set of biomarkers to predict therapeutic efficacy, but its value in predicting therapy responses to acupuncture in patients with depression is unknown. Here we analyzed the predictive value of the gut microbiota in patients with postpartum depressive disorder (PPD) treated with acupuncture.Methods: Seventy-nine PPD patients were enrolled: 55 were treated with acupuncture and 24 did not received any treatment. The 17-item Hamilton depression rating scale (HAMD-17) was used to assess patients at baseline and after eight weeks. Patients receiving acupuncture treatment were divided into an acupuncture-responsive group or non-responsive group according to HAMD-17 scores changes. Baseline fecal samples were obtained from the patients receiving acupuncture and were analyzed by high-throughput 16S ribosomal RNA sequencing to characterize the gut microbiome.Results: 47.27% patients responded to acupuncture treatment and 12.5% patients with no treatment recovered after 8-week follow-up. There was no significant difference in α-diversity between responders and non-responders. The β-diversity of non-responders was significantly higher than responders. Paraprevotella and Desulfovibrio spp. were significantly enriched in acupuncture responders, and these organisms had an area under the curve of 0.76 and 0.66 for predicting responder patients, respectively.Conclusions: Paraprevotella and Desulfovibrioare may be useful predictive biomarkers to predict PPD patients likely to respond to acupuncture. Larger studies and validation in independent cohorts are now needed to validate our findings.

Background: Acupuncture is widely used for analgesia in China and western countries. Lateral epicondylitis (LE) is a common disease, which influences the quality of life for many patients. The clinical practice indicates that acupuncture has a therapeutic effect on the LE; however, whether acupuncture is superior to sham acupuncture and some conventional therapy methods has been controversial. Hence, we will provide a protocol to explore the effectiveness and safety for acupuncture for LE. Methods: We will search only the randomized controlled trials (RCTs) literatures of acupuncture for LE from the following seven databases, including PubMed, Cochrane Central Register of Controlled Trials (The Cochrane Library), Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Data, and Chinese Scientific Journals Database (VIP). The Visual Analogue Scale (VAS) will be considered as the primary outcome and the secondary outcome will include effective rate and function recovery. Adverse events incidence caused by acupuncture will also be discussed, such as dizziness, nausea, vomiting, and weariness. The searching strategy, inclusion and exclusion criteria were made according to the principle of evidence-based medicine. The quality was evaluated by Cochrane Handbook for Systematic Reviews of Interventions (V5.1). All analyses will be conducted by Review Manager Software (V5.3). Result: The results of this review will be submitted to a recognized journal for publication. Conclusion: This proposed meta-analysis will assess the efficacy and safety of acupuncture therapy for LE.