Background. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex male dysfunction, mostly seen in young and middle-aged men with a history of more than 3months. As a traditional therapy of Traditional Chinese Medicine, acupuncture has been proven an effective method to treat CP/CPPS in recent years. Though some meta-analyses on acupuncture for chronic prostatitis were published in 2018 and 2019, most of the included studies were low in quality according to the JADAD score (JADAD<4). The conclusions of acupuncture for CP/CPPS remain indefinite. Purpose. This review aims to evaluate the efficacy of acupuncture for CP/CPPS by including high-quality literature only (JADAD4) to provide a reliable basis for clinical applications and research. Method. Nine electronic databases were searched from inception to March 1, 2022, and only randomized controlled trials (RCT) with high-quality (JADAD4) were included. Data were analyzed using Review Manager 5.3. and was verified through trial sequential analysis (TSA). We carried out a sensitivity analysis for the heterogeneity (I²50). Publication bias was explored using a funnel plot. Result. Ten RCTs (11 trials) of high-quality methodology involving 798 patients were included. Meta-analysis showed that compared to sham acupuncture (SAT) and western medicine (WM), acupuncture (AT) played superior roles for CP/CPPS patients in pain score, NIH-CPSI score, quality of life score, urinary symptom, and efficacy rate. As for the adverse effects, 4 RCTs described mild hematoma and pain in AT and SAT groups, while specific symptoms including nausea, abdominal pain, dizziness, and low blood pressure were reported in WM groups. Conclusion. This meta-analysis indicated that acupuncture has measurable benefits on CP/CPPS, and security has also been ensured. However, this meta-analysis only included 10 RCTs; thus, RCTs with a larger sample size and longer-term observation are required to verify the effectiveness of acupuncture further in the future.

Introduction Lateral ankle sprains are one of the most common musculoskeletal injuries. Up to 70% of individuals who sustain lateral ankle sprains develop chronic ankle instability (CAI). Balance training has been used in patients with CAI, but the evidence for its efficacy is inconsistent. This systematic review and meta-analysis aims to determine the short-term (end of the treatment period) and long-term (6 months after treatment) effectiveness of balance training for patients with CAI. Methods and analysis We will search PubMed, EMBASE, the Cochrane Library, Ovid, EBSCO-host, Pedro, ClinicalKey, ScienceDirect, Springer, China National Knowledge Infrastructure, Technology Periodical Database (VIP), WanFang Data and China Biology Medicine for reports of randomised trials of balance training in patients with CAI, from inception to 1 October 2021. The language will be restricted to English and Chinese, and articles will be screened and collected by two reviewers independently. Dynamic balance and functional ankle instability are the primary outcomes of this study. Secondary outcomes include pain, ankle range of motion, ankle strength and health-related quality of life. Review Manager V.5.3 software will be used for meta-analysis, and stratification analysis will be conducted for study quality according to the Jadad score. Subgroup and sensitivity analyses will be conducted. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess confidence in the cumulative evidence. The protocol follows the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. Ethics and dissemination Ethical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publications.

Objective: To evaluate the effect of low-frequency (≤1 Hz) repetitive transcranial magnetic stimulation (low-frequency rTMS) combined with antidepressants on depression and the levels of inflammatory factors IL-6 and TNF-α in patients with post-stroke depression (PSD).Design: PubMed, Embase, Web of Science, Cochrane Library (CBM), China National Knowledge Infrastructure, Technology Periodical Database, and Wanfang Database were searched until October 2022 for randomized controlled trials.Participants: Patients with post-stroke depression (PSD) participated in the study.Results: A total of 16 randomized controlled trials (RCTs) involving 1,463 patients with PSD were included. According to the Physiotherapy Evidence Database (PEDro) quality assessment, three studies received high quality (eight scores) and 13 RCTs received moderate quality (six scores) results. The meta-analysis showed that low-rTMS combined with an antidepressant significantly reduced the Hamilton Depression Scale (HAMD) score and the National Institutes of Health Stroke Scale (NIHSS) score, reduced IL-6 and TNF-α levels, and improved the MMSE score in PSD compared to an antidepressant alone.Conclusion: The results of this meta-analysis evidenced the efficacy and safety of low-rTMS combined with antidepressants in the treatment of depression in PSD patients. The combined therapy could reduce The depression state and the levels of IL-6 and TNF-α, and enhance the cognitive function of patients. In addition, low-rTMS had fewer adverse effects, proving safety. However, there are shortcomings, such as a lack of long-term follow-up, different intervention sites of low-rTMS, and different intervention frequencies (0.5 or 1 Hz). Thus, in the future, RCTs with a larger sample size and longer-term observation are required to verify the efectiveness of low-rTMS combined therapy on PSD. Meantime, a new meta-analysis could be analysized, which intervention sites and frequency are more effective in treating PSD.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022376845.

Background: Dyskinesia is a common manifestation after stroke. Motor functional rehabilitation after stroke is of great significance to the maintenance of national health. Ocular Acupuncture Kinesitherapy (OAKT) can repair nerve injuries, improve motor function, reduce rehabilitation time, and promote dyskinesia recovery after stroke. The mechanism, however, remains a mystery, necessitating urgent research. The M1-thalamus-spinal cord neural signaling pathway is linked to limb motor function. Bold-fMRI can represent the cerebral functional state, and TMS-MEP is of certain practical utility for assessing motor neural function and prognosis. Combining fMRI scanning with TMS-MEP detection is predicted to advance brain-spinal cord regulation and muscle response linkage control mechanism research, as well as completely investigate the central-peripheral coupling effect of Ocular Acupuncture Kinesitherapy on dyskinesia after stroke (PSD).Methods: This is a prospective functional neuroimaging and neurotic electrophysiological study with a case-control design between the PSD with the HC groups and a randomized controlled design within the 3 PSD groups (OAKT group, ocular acupuncture group, and kinesitherapy group). Using fMRI scans and TMS-MEP approach, we will assess the central-peripheral neural function alterations in PSD as well as the coupling effects of OAKT on PSD. We plan to enroll 90 participants at the Hospital of Chengdu University of Traditional Chinese Medicine from Aug 31, 2022, to Dec 31, 2023, including 45 PSD and 45 HC subjects. After enrollment and on the last day after 4-weeks of waiting (HC subjects) or intervention (PSD subjects), all eligible subjects will be evaluated using fMRI scanning, TMS-MEP detection, and the MMT and Fugl-Mayer scales assessment. The MMT and Fugl-Meyer scores will be recorded, and a Pearson correlation analysis will be performed to assess the correlation between clinical and imaging outcomes.Discussion: Findings of this study will help to explain the central-peripheral coupling effect of OAKT on PSD and to further provide the neural processing of acupuncture kinesitherapy covering the entire pathway from peripheral to central nervous system.Clinical trial registration: This study is registered with an identifier (ChiCTR2200060483) at the Chinese Clinical Trial Registry in June 2022. http://www.chictr.org.cn/index.aspx.

This study aimed to investigate the effect of Fuzheng Yiai Decoction (FZYA) on epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) drug resistance in lung adenosquamous carcinoma (ASC). The expression of thyroid transcription factor 1 (TTF1) and p63 in tumor cells was observed by immunofluorescence staining. Meanwhile, 25 nude mice successfully inoculated with the human lung ASC cell line NCI‐H596 were randomly divided into five groups, namely, the model, gefitinib, low‐, medium‐, and high‐dose FZYA with gefitinib groups. After four weeks of daily intragastric administration of the various treatments, the tumor weight and volume inhibition rates were calculated. The positive expression rate and protein expression of TTF1 and p63 in mouse tumor tissues were evaluated by immunohistochemistry and western blot assays. The results showed that the adenocarcinoma part and the squamous cell carcinoma part of the lung tissue were not either one or the other, and each had unique biological behavior patterns. In terms of the tumor volume and weight, gefitinib treatment along with FZYA reduced the acquired resistance of EGFR‐TKIs in lung ASC, and its inhibitory effect was superior to EGFR‐TKI (gefitinib) treatment alone. Moreover, it was discovered that FZYA inhibited the pedigree transformation among cancer subtypes due to EGFR‐TKI treatment. In conclusion, the application of FZYA inhibited the pedigree transformation among lung cancer subtypes, thus increasing the tumor inhibitory effect and decreasing the EGFR‐TKI drug resistance of tumor cells.

Objective: The aim of the study is to investigate the effects of core strengthening exercises on pain, mobility, and lower limb muscle strength in patients with patellofemoral pain syndrome. Design: Six databases were searched from inception until August 11, 2023. Pain, function, and muscle strength-related outcomes were extracted and the quality of the studies was assessed using the PEDro scale and the level of evidence was assessed using the GRADE. Results: Nineteen studies involving 1138 patients were included. Very low-grade evidence supported the short-term pain-relieving effect of core training (standardized mean difference = −0.60, 95% confidence interval [−0.95, −0.25]), high-grade evidence supported the short-term functional improvement effects of core training (weighted mean difference = 3.61, 95% confidence interval [1.44, 5.78]), which was similarly significant within 3–12 mos of follow-up. The results of the subgroup analyses suggested that hip-knee training was most advantageous in relieving pain and enhancing motor function. Conclusions: Although training that includes trunk core is clearly superior to knee strengthening alone, the effectiveness of hip-knee training, which is also a core training program for pain and function, is more pronounced. The available evidence supports that hip-knee training is the most valuable treatment option for patients with patellofemoral pain syndrome.